摘要
目的:观察预防性使用氨甲环酸减少高危妊娠剖宫产出血的临床效果。方法:选取2021年8月—2023年12月萍乡市妇幼保健院收治的80例高危妊娠孕妇,均经剖宫产终止妊娠,依照随机数字表法分为观察组(n=40)、对照组(n=40)。术前20 min观察组将1.0 g氨甲环酸注射液加入100 mL 0.9%氯化钠注射液中静滴,对照组静滴复方氯化钠注射液120 mL,断脐后均宫体注射缩宫素注射液10 U。比较两组围手术期相关参数、产后出血与凝血功能[凝血酶原时间(PT)、D-二聚体(D-D)等]差异,对比两组新生儿不良事件、不良反应发生情况。结果:观察组住院时间、血性恶露持续时间均短于对照组,缩宫素使用量少于对照组,观察组宫缩持续时间较对照组延长,而子宫底下降速度大于对照组(P<0.05),两组手术时间差异无统计学意义(P>0.05);观察组产时、术后2 h、术后24 h的出血量及产后出血率均低于对照组(P<0.05);两组术后24 h纤维蛋白原(FIB)、纤维蛋白原降解产物(FDP)均高于术前,活化部分凝血活酶时间(APTT)、PT均短于术前,D-D均低于术前,且观察组术后24 h FIB、FDP均高于对照组,APTT、PT均短于对照组,D-D低于对照组(P<0.05);两组新生儿窒息发生率、不良反应发生率差异均无统计学意义(P>0.05)。结论:对于高危妊娠剖宫产产妇,在术前预防性使用氨甲环酸可促进产后恢复,明显减少出血,调节凝血功能,而不增加新生儿不良事件及不良反应发生风险。
Objective:To observe the clinical effect of prophylactic use of Tranexamic Acid in reducing bleeding during caesarean section of high-risk pregnancy.Method:Eighty high-risk pregnant women admitted to Pingxiang Maternal and Child Health Hospital from August 2021 to December 2023 were selected,all of whom were terminated by cesarean section,and divided into observation group(n=40)and control group(n=40)according to random number table method.20 min before operation,the observation group added 1.0 g Tranexamic Acid Injection into 100 mL 0.9%Sodium Chloride Injection,and the control group received intravenous infusion of 120 mL of Compound Sodium Chloride Injection.After the umbilical cord was cut,both groups were given intrauterine injection of 10 U of Oxytocin Injection.The differences of perioperative parameters,postpartum hemorrhage and coagulation function[prothrombin time(PT),D-dimer(D-D),etc]between the two groups were compared,and the incidence of neonatal adverse events and adverse reactions were compared between the two groups.Result:The length of hospital stay and duration of lochia rubra in the observation group were shorter than those in the control group,and the amount of Oxytocin was less than that in the control group,the duration of uterine contraction in the observation group was longer than that in the control group,and the descending speed of uterine floor was greater than that in the control group(P<0.05);there was no statistically significant difference in operation time between the two groups(P>0.05).The amount of blood loss during childbirth,2 h and 24 h after surgery and the rate of postpartum hemorrhage in the observation group were lower than those in the control group(P<0.05).Fibrinogen(FIB)and fibrinogen degradation product(FDP)in both groups 24 h after operation were higher than those before operation,activated partial thromboplastin time(APTT)and PT were shorter than those before operation,D-D were lower than those before operation,FIB and FDP in observation group were higher than those in control group 24 h after operation,APTT and PT were shorter than those in control group,and D-D was lower than that of control group(P<0.05).There were no significant differences in the incidence of neonatal asphyxia and the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Prophylactic administration of Tranexamic Acid before operation can promote postpartum recovery,significantly reduce bleeding and regulate coagulation function,but does not increase the risk of neonatal adverse events and adverse reactions.
作者
王珊
张劲宜
李月芬
刘俊
WANG Shan;ZHANG Jinyi;LI Yuefen;LIU Jun(Department of Gynaecology and Obstetrics,Pingxiang Maternal and Child Health Hospital,Pingxiang 337000,China;不详)
出处
《中国医学创新》
CAS
2024年第17期41-45,共5页
Medical Innovation of China
基金
萍乡市科技计划项目(2023PY121)。
关键词
预防
氨甲环酸
高危妊娠
剖宫产
产后出血
Prevention
Tranexamic Acid
High-risk pregnancy
Cesarean section
Postpartum hemorrhage
