葆宮止血顆粒聯(lián)合卡前列素氨丁三醇注射液對(duì)剖宮產(chǎn)產(chǎn)后出血的防治研究

1、葆宮止血顆粒聯(lián)合卡前列素氨丁三醇注射液對(duì)剖宮產(chǎn)產(chǎn)后出血的防治研究葆宮止血顆粒聯(lián)合卡前列素氨丁三醇注射液對(duì)剖宮產(chǎn)產(chǎn)后出血的防治討論1959202106-0154-03Abstract：Objective To analyze the clinical value of combined use ofBaogong ZhixueGranulesand Carboprost tromethamine injectionin the prevention and treatment of postpartum hemorrhage in cesarean section.Methods The cli

2、nical data of 61 women who underwent cesarean section in our hospital from August 2021 to August 2021 were retrospectively analyzed. According to the treatment methods， they were divided into two groups， A and B. 32 patients in group A were treated with Baogong Zhixue Granules and Carprostol trometh

3、amine injection to prevent postpartum hemorrhage. 29 patients in group B were treated with only carprostol tromethamine injection. The coagulation function FIB， TT， D-D， APTT of the two groups before and after treatment， postpartum hemorrhage， uterine contraction and lochia maintenance time， and ute

4、rine fundus fall rate.Results The FIB， D-D， TT and APTT in group A were lower than those in group B，the difference was statistically significant P0.05. The blood loss in group A was lower than that in group B at 24 hours after birth 315.74±63.20 ml vs 463.01±50.43 ml， the difference was st

5、atistically significant P0.05;The postpartum hemorrhage rate in group A was lower than that in group B，the difference was statistically significant P0.05. The number of days of contraction in group A was shorter than that in group B 1.52±0.47d vs 3.02±0.54d， the difference was statisticall

6、y significant P0.05;The descending rate of uterine fundus in group A was higher than that in group B， and the number of days of lochia was shorter than that in group B， the difference was statistically significant P0.05. Conclusion Prevention and treatment of postpartum hemorrhage in cesarean sectio

7、n the combination of Baogong Zhixue Granules and Carprostol tromethamine injection can improve maternal coagulation function， reduce postpartum hemorrhage 24 hours， reduce postpartum hemorrhage rate， accelerate uterine bottom rate， and shorten uterine contraction Time and lochia maintain time， and t

8、he application effect is better. 400 ml或24 h內(nèi)>500 ml，具有誘發(fā)出血性休克的風(fēng)險(xiǎn)，甚至導(dǎo)致產(chǎn)婦死亡2。當(dāng)前臨床上通常將縮宮素作為治療產(chǎn)后出血的一線(xiàn)藥物，其優(yōu)點(diǎn)為起效快、效果好，但存在肯定的局限性，如半衰期短，需要持續(xù)注射等。因此臨床上漸漸加強(qiáng)了對(duì)聯(lián)合用藥的討論力度，西藥代表藥物卡前列素氨丁三醇注射液與中成藥代表藥物葆宮止血顆粒廣受關(guān)注。為驗(yàn)證其療效，本討論將分析剖宮產(chǎn)產(chǎn)后出血防治中葆宮止血顆粒與卡前列素氨丁三醇注射液聯(lián)用的臨床價(jià)值，現(xiàn)報(bào)道如下。1資料與方法1.1一般資料 回憶性分析2021年8月2021年8月在佳木斯大學(xué)附屬第一醫(yī)院婦產(chǎn)科

9、行剖宮產(chǎn)的61例產(chǎn)婦的臨床資料，依據(jù)治療方法將其分為A、B兩組。A組產(chǎn)婦32例，年齡2139歲，平均年齡30.51±4.69歲，孕周3641周，平均孕周38.51±1.49周，孕產(chǎn)次14次，平均2.39±0.56次;B組產(chǎn)婦29例，年齡2140歲，平均年齡30.71±4.55歲，孕周3640周，平均孕周38.21±1.48周，孕產(chǎn)次14次，平均2.42±0.61次。兩組產(chǎn)婦年齡、孕周等一般資料比較，差異無(wú)統(tǒng)計(jì)學(xué)意義P>0.05，討論可進(jìn)行。本討論經(jīng)我院倫理委員會(huì)審批通過(guò)，全部患者均簽署知情同意書(shū)。1.2入選和排除標(biāo)準(zhǔn) 入選標(biāo)準(zhǔn)：

10、單胎妊娠、符合剖宮產(chǎn)手術(shù)指征、具有子宮收縮乏力等高危因素、資料完好。排除標(biāo)準(zhǔn)：血液系統(tǒng)疾病、自身免疫系統(tǒng)疾病、肝腎疾病、妊娠前高血壓、過(guò)敏體質(zhì)產(chǎn)婦。1.3方法 兩組均行子宮下段橫切口剖宮產(chǎn)術(shù)，在胎兒娩出后，A組行卡前列素氨丁三醇注射液進(jìn)口藥品：美國(guó) Pharmacia Upjohn;批準(zhǔn)文號(hào)：國(guó)藥準(zhǔn)字H20214183;規(guī)格：1 ml250 g宮體內(nèi)注射，用量為250 g;葆宮止血顆粒生產(chǎn)單位：天津中盛海天制藥有限公司;批準(zhǔn)文號(hào)：國(guó)藥準(zhǔn)字Z20213059;規(guī)格：15 g產(chǎn)后6 h口服，2 次/d，15 g/次，連續(xù)用藥7 d。B組僅使用卡前列素氨丁三醇注射液治療，用法與用量同A組。1.4觀看指標(biāo) 比較兩組產(chǎn)婦凝血功能，包括纖維蛋白原FIB、凝血酶原時(shí)間TT、D-二聚體D-D、活化部分凝血酶原時(shí)間APTT，產(chǎn)婦空腹時(shí)抽取35 ml肘靜脈血，使用全自動(dòng)生化分析儀羅氏COBAS INTEGRA 800檢測(cè)。記錄兩組產(chǎn)婦產(chǎn)后出血狀況、宮縮與惡露維持時(shí)間、子宮底下降速度。產(chǎn)后出血狀況推斷指標(biāo)包括產(chǎn)后24 h失血量、產(chǎn)后出血率;每天使用皮尺對(duì)宮底高度進(jìn)行測(cè)量，子宮底下降速度=2次測(cè)量差值/時(shí)間間隔。1.5統(tǒng)計(jì)學(xué)分析 試驗(yàn)數(shù)據(jù)使用SPSS26.0統(tǒng)計(jì)學(xué)軟件處理，計(jì)量資料使用x