摘要
目的:探究氨甲环酸联合欣母沛在宫缩乏力性产后出血患者中的应用及对凝血功能的影响。方法:纳入我院2022年1月至2025年1月收治的宫缩乏力孕妇,将其按随机数字表法分为欣母沛组与联合组(n=30),分别予以欣母沛250μg·次^(-1)肌肉注射治疗以及欣母沛+氨甲环酸静脉滴注治疗,观察产妇出血情况(产后2 h出血量、产后24 h出血量、止血起效时间)。在治疗前及治疗24 h使用全自动凝血分析仪测定凝血酶原时间(Prothrombin time,PT)、活化部分凝血活酶时间(Activated partial thromboplastin time,APTT)、纤维蛋白原(Fibrinogen,FIB)、D-二聚体,使用免疫散射比浊法测定C-反应蛋白(C-reactive protein,CRP)水平,并观察治疗期间的不良反应。结果:联合组产后2 h、24 h出血量、止血起效时间均显著低于欣母沛组(P<0.05);产后24 h,两组PT、APTT、D-二聚体、CRP均显著降低(P<0.05),其中联合组显著低于欣母沛组(P<0.05),两组FIB显著升高(P<0.05),且联合组显著高于欣母沛组(P<0.05);联合组的不良反应总发生率(16.67%)与欣母沛组不良反应发生率(13.33%)无显著差异(P>0.05)。结论:氨甲环酸联合欣母沛可有效控制宫缩乏力性产后出血,增强凝血功能并减轻炎症反应,且安全性较好。
Objective:To explore the application of tranexamic acid combined with hemabate on patients with postpartum hemorrhage due to uterine inertia and its influence on coagulation function.Methods:Pregnant women with uterine inertia who were admitted to the hospital from January 2022 to January 2025 were included and divided into the hemabate group(n=30)and the combined group(n=30)by random number table method.They were given an intramuscular injection of 250μg·time^(-1) of hemabate and hemabate+intravenous drip of tranexamic acid,respectively.The maternal hemorrhage conditions(2 h postpartum hemorrhage volume,24 h postpartum hemorrhage volume,and hemostasis onset time)were observed.Before treatment and after 24 hours of treatment,an automatic coagulation analyzer was used to detect prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),and D-dimer,and immunonephelometry was used to measure C-reactive protein(CRP),and the adverse reactions during treatment were observed.Results:The 2 h and 24 h postpartum hemorrhage volumes and onset time of hemostasis in the combined group were significantly less or shorter than those in the hemabate group(P<0.05).At 24 h after delivery,PT,APTT,D-dimer and CRP in the two groups were significantly decreased(P<0.05),and the indexes in combined group were significantly lower than those in hemabate group(P<0.05),and FIB in the two groups was increased significantly(P<0.05),and FIB in combined group was significantly higher than that in hemabate group(P<0.05).There was no significant difference in the total incidence rate of adverse reactions between the combined group(16.67%)and the hemabate group(13.33%)(P>0.05).Conclusion:The combination of tranexamic acid and hemabate can effectively control postpartum hemorrhage due to uterine inertia,enhance the coagulation function and relieve the inflammatory response,with good safety.
作者
邹茵侠
王珊
Zou Yin-xia;Wang Shan(Department of Obstetrics,Pingxiang Maternal and Child Health Hospital,Pingxiang 337000,Jiangxi,China;Department of Obstetrics and Gynecology,Pingxiang Maternal and Child Health Hospital,Pingxiang 337000,Jiangxi,China)
关键词
氨甲环酸
欣母沛
宫缩乏力性产后出血
凝血功能
Tranexamic acid
Hemorrhage
Postpartum hemorrhage due to uterine inertia
Coagulation function
