【摘要】：目的:探討益母草注射液聯(lián)合卡前列素氨丁三醇預(yù)防剖宮產(chǎn)產(chǎn)后出血療效及對患者纖維蛋白原(FIB),D-二聚體(D-dimer)水平的影響。方法:140例具有產(chǎn)科剖宮產(chǎn)指征及宮縮乏力高危因素的產(chǎn)婦按隨機數(shù)字表法隨機分為對照組(n=70)和觀察組(n=70)。對照組在胎兒娩出后給予卡前列素氨丁三醇子宮宮體注射,觀察組在對照組的基礎(chǔ)上聯(lián)合應(yīng)用益母草注射液肌肉注射。觀察比較兩組患者術(shù)后2,24 h出血量、產(chǎn)后出血發(fā)生率、藥物注射后宮縮持續(xù)時間、產(chǎn)后子宮底下降速度、惡露持續(xù)時間、治療前后FIB,D-dimer水平及不良反應(yīng)發(fā)生情況。結(jié)果:與對照組相比,觀察組術(shù)后2,24 h出血量顯著減少(234.5±50.2)VS(356.2±51.5),(309.7±64.5)VS(443.3±68.6)m L,產(chǎn)后出血發(fā)生率明顯降低(4.3%VS14.3%),藥物注射后宮縮持續(xù)時間顯著延長(3.43±1.03)VS(1.62±0.54)h,產(chǎn)后子宮底下降速度更快(1.15±0.24)VS(0.56±0.13)cm·d-1,惡露持續(xù)時間明顯縮短(14.8±4.7)VS(21.5±6.2)d,FIB,D-dimer水平顯著下降(3.50±0.24)VS(4.61±0.42)g·L-1,(1.21±0.23)VS(3.47±0.29)mg·L-1,比較都有統(tǒng)計學(xué)差異(P0.05)。治療過程中,未出現(xiàn)嚴(yán)重不良反應(yīng),且不良反應(yīng)發(fā)生率組間比較無統(tǒng)計學(xué)差異(18.6%VS 21.4%)。結(jié)論:益母草注射液聯(lián)合卡前列素氨丁三醇是剖宮產(chǎn)產(chǎn)后出血的一種有效預(yù)防方案,能夠顯著減少術(shù)后出血量,降低產(chǎn)后出血發(fā)生率,延長宮縮時間,促進產(chǎn)后恢復(fù),改善血液高凝狀態(tài),且不良反應(yīng)輕微,臨床上值得進一步研究。
[Abstract]:Objective: to investigate the effect of Herba Leonurus injection combined with carprostatin aminobutanol on prevention of postpartum hemorrhage in cesarean section and its effect on fibrinogen (FIB), D dimer (D-dimer) level. Methods: 140 pregnant women with indications of cesarean section and high risk factors of uterine inertia were randomly divided into control group (n = 70) and observation group (n = 70). The control group was given intrauterine injection of carprostatin aminobutanol after delivery, and the observation group was injected intramuscularly with Leonurus injection on the basis of the control group. The amount of blood loss, the incidence of postpartum hemorrhage, the duration of uterine contraction after drug injection, the decreasing rate of postpartum uterine floor, the duration of lochia, the level of FIB,D-dimer before and after treatment and the occurrence of adverse reactions were observed and compared between the two groups. Results: compared with the control group, the blood loss at 24 hours after operation in the observation group was significantly decreased (234.5 鹵50.2) VS (, 356.2 鹵51.5), (, 309.7 鹵64.5) VS (, 443.3 鹵68.6) m L,). The incidence of postpartum hemorrhage was significantly decreased (4.3% vs 14.3%), and the duration of uterine contraction was significantly prolonged (3.43 鹵1.03) VS (1.62 鹵0.54 h) after injection. Postpartum uterine floor decreased more rapidly (1.15 鹵0.24) VS (, 0.56 鹵0.13 cm d -1), and the duration of lochia decreased significantly (14.8 鹵4.7) VS (21.5 鹵6.2 d). The levels of D-dimer decreased significantly (3.50 鹵0.24) VS (4.61 鹵0.42) g L-1 and (1.21 鹵0.23) VS (3.47 鹵0.29) mg L-1, respectively (P0.05). In the course of treatment, there were no serious adverse reactions, and there was no significant difference in the incidence of adverse reactions among the groups (18.6%VS 21.4%). Conclusion: Herba Leonurus injection combined with carprostatin aminobutanol is an effective prophylaxis of postpartum hemorrhage in caesarean section. It can significantly reduce the amount of postpartum hemorrhage, reduce the incidence of postpartum hemorrhage, prolong the time of uterine contraction and promote postpartum recovery. The improvement of hypercoagulability and mild adverse reactions are worthy of further study.
【作者單位】： 臨沂市沂水中心醫(yī)院;成都中醫(yī)藥大學(xué);
【基金】：國家自然科學(xué)基金青年基金項目(81303209)
【分類號】：R719.8

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