麦角新碱联合氨甲环酸治疗产后宫缩乏力性出血的临床效果以及对子宫复旧、凝血功能的影响  

Clinical effect of Ergometrine combined with Tranexamic Acid in the treatment of postpartum uterine atony and bleeding and its influence on involution of uterus and coagulation function

作　　者：张美琳 于楠楠 ZHANG Meilin YU Nannan(Department of Obstetrics,Sanming Second Hospital,Fujian Province,Sanming366000,China)

机构地区：[1]福建省三明市第二医院产科,福建三明366000

出　　处：《中国当代医药》2024年第33期88-91,共4页China Modern Medicine

摘　　要：目的探讨麦角新碱联合氨甲环酸治疗产后宫缩乏力性出血的临床效果及对子宫复旧、凝血功能的影响。方法选取2023年1月至2024年5月三明市第二医院60例剖宫产后宫缩乏力性出血产妇作为研究对象,按照随机数字表法分为观察组与对照组,每组各30例。两组患者均给予缩宫素,在此基础上,对照组予以氨甲环酸治疗,观察组予以麦角新碱联合氨甲环酸治疗,比较两组患者产后出血量、凝血功能[纤维蛋白原(FIB)、凝血酶原时间(PT)、D-二聚体、活化部分凝血活酶时间(APTT)]、子宫复旧情况、血压[收缩压(SBP)、舒张压(DBP)]水平,以及不良反应发生率。结果观察组产后2、24 h出血量少于对照组同期,差异有统计学意义(P<0.05);观察组产后24 h时APTT、PT时间短于对照组,血浆D-二聚体、FIB水平高于对照组,差异有统计学意义(P<0.05);观察组产后1、3、5 d时宫底高度均小于对照组同期,差异有统计学意义(P<0.05);两组患者给药后30 min、1 h时SBP、DBP水平比较,差异无统计学意义(P>0.05);两组患者不良反应总发生率比较,差异无统计学意义(P>0.05)。结论麦角新碱、氨甲环酸联合可减少产后宫缩乏力性出血量,改善机体凝血,促进子宫复旧,具有较高的用药安全性。Objective To investigate the clinical effect of Ergometrine combined with Tranexamic Acid in the treatment of postpartum uterine atony and bleeding and its influence on involution of uterus and coagulation function.Methods A total of 60 cases of women with uterine atony and bleeding after cesarean section from January 2023 to May 2024 in Sanming Second Hospital were selected as research objects,and they were divided into observation group and control group according to random number table method,with 30 cases in each group.Both groups were given Oxytocin.On this basis,the control group was treated with Tranexamic Acid,and the observation group was treated with Ergometrine combined with Tranexamic Acid.Postpartum blood loss,coagulation function(fibrinogen[FIB],prothrombin time[PT],D-dimer,activated partial thromboplastin time[APTT]),involution of uterus,blood pressure(systolic blood pressure[SBP],diastolic blood pressure[DBP])and incidence of adverse reactions were compared between the two groups.Results The blood loss at 2 h and 24 h postpartum in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).At 24 h postpartum,APTT and PT in observation group were shorter than those in control group,and plasma D-dimer and FIB levels were higher than those in control group,the differences were statistically significant(P<0.05).At 1,3 and 5 days postpartum,the fundal height in the observation group were lower than those in the control group,with statistical significances(P<0.05).There were no significant differences in SBP and DBP levels between two groups at 30 min and 1 h after administration(P>0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion The combination of Ergometrine and Tranatemyclic Acid can reduce the amount of blood loss caused by postpartum uterine atony and bleeding,improve blood coagulation,promote involution of uterus,and have high drug safety.

关 键 词：产后宫缩乏力性出血 氨甲环酸 麦角新碱 凝血功能 子宫复旧 

分 类 号：R714.46[医药卫生—妇产科学]