摘要
目的探讨固元复旧汤联合卡前列素氨丁三醇对阴道分娩宫缩乏力性产后出血的预防效果。方法选择2018年4月至2020年6月于该院就诊的有宫缩乏力性产后出血倾向的住院产妇110例为研究对象,分为对照组和观察组,每组55例。对照组产妇于胎儿娩出后给予肌内注射卡前列素氨丁三醇,观察组产妇在对照组基础上口服固元复旧汤。比较2组产妇产后出血率、产后出血量、产后止血时间、其他止血措施的应用情况、血红蛋白及血细胞比容的变化,检测血清中相关因子水平,记录不良反应。结果观察组产妇的产后出血率(3.64%)显著低于对照组(14.55%),差异有统计学意义(χ^(2)=3.960,P<0.05)。观察组产妇的产后止血时间[(23.56±3.14)min]显著短于对照组[(40.05±5.74)min],差异有统计学意义(t=18.691,P<0.05)。与对照组比较,观察组产妇产后30 min、产后2 h、产后24 h的出血量均显著减少(t=8.654、13.495、15.496,P<0.05)。观察组产妇其他止血措施的应用率(7.27%)显著低于对照组(21.82%),差异有统计学意义(χ^(2)=4.681,P<0.05)。与对照组比较,观察组产妇血红蛋白的下降幅度、血细胞比容降低幅度均显著减小(t=22.817、28.939,P<0.05)。与对照组比较,观察组产后2 h血清中D-二聚体水平显著降低,FIB水平显著升高(t=19.492、17.256,P<0.05)。观察组产妇产后2 h血清中抗凝血酶-Ⅲ水平显著升高,一氧化氮水平显著降低(t=6.090、10.092,P<0.05)。观察组的不良反应发生率(7.27%)低于对照组(16.36%),但差异无统计学意义(χ^(2)=2.181,P>0.05)。结论固元复旧汤联合卡前列素氨丁三醇可预防阴道分娩宫缩乏力性产后出血,减少产后出血量,改善凝血功能,促进子宫收缩,用药安全性高。
Objective To observe the preventive effect of Guyuan Fujiu decoction combined with carboprost tromethamine on postpartum hemorrhage caused by uterine inertia in vaginal delivery.Methods A total of 110 cases of postpartum hemorrhage due to uterine inertia in the hospital from April 2018 to June 2020 were randomly divided into control group and observation group,55 cases in each group.The control group was given carboprost tromethamine injection after the delivery of the fetus,and the observation group was given Guyuan Fugu decoction on the basis of the control group.The incidence of postpartum hemorrhage,amount of postpartum hemorrhage,hemostatic time,use of other hemostatic measures,changes of hemoglobin and hematocrit were compared between the two groups.Results The postpartum hemorrhage rate of the observation group(3.64%)was significantly lower than that of the control group(14.55%),the difference was statistically significant(χ^(2)=3.960,P<0.05).Postpartum hemostasis time[(23.56±3.14)min]was significantly shorter than that in the control group[(40.05±5.74)min],the difference was statistically significant(t=18.691,P<0.05).Compared with the control group,the amount of bleeding in the observation group decreased significantly at 30 min,2 h and 24 h postpartum(t=8.654,13.495 and 15.496,P<0.05).The application rate of other hemostatic measures in the observation group(7.27%)was significantly lower than that in the control group(21.82%)(χ^(2)=4.681,P<0.05).Compared with the control group,the decrease of maternal hemoglobin and hematocrit in the observation group were significantly reduced(t=22.817,28.939,P<0.05).Compared with the control group,the serum D-dimer level in the observation group was significantly lower at 2 h postpartum,and the FIB level was significantly higher(t=19.492,17.256,P<0.05).The level of serum antithrombin-Ⅲin the observation group was significantly higher than that in the control group(t=6.090,10.092,P<0.05).The adverse reaction rate of the observation group(7.27%)was lower than that of the control group(16.36%),but the difference was not statistically significant(χ^(2)=2.181,P>0.05).Conclusion Guyuan Fuguo decoction combined with carboprost tromethamine can be used to prevent uterine hypostasis postpartum hemorrhage,reduce postpartum hemorrhage,improve coagulation function,promote uterine contraction and drug safety.
作者
林文静
李海波
LIN Wenjing;LI Haibo(Department of Obstetrics,Baoji Central Hospital,Baoji,Shaanxi 721008,China)
出处
《检验医学与临床》
CAS
2021年第16期2335-2338,2343,共5页
Laboratory Medicine and Clinic
关键词
固元复旧汤
卡前列素氨丁三醇
阴道分娩
宫缩乏力性
产后出血
Guyuan Fujing decoction
carboprost tromethamine
vaginal delivery
uterine inertia
postpartum hemorrhage
