中国医药
中國醫藥
중국의약
China Medicine
2015年
10期
1521-1523
,共3页
剖宫产%产后出血%氨甲环酸%卡前列素氨丁三醇注射液%纤维蛋白原%血小板
剖宮產%產後齣血%氨甲環痠%卡前列素氨丁三醇註射液%纖維蛋白原%血小闆
부궁산%산후출혈%안갑배산%잡전렬소안정삼순주사액%섬유단백원%혈소판
Cesarean section%Postpartum hemorrhage%Tranexamic acid%Carboprost tromethamine%Fibrinogen%Platelet
目的 探讨氨甲环酸联合卡前列素氨丁三醇注射液对剖宫产后出血的预防作用及对纤维蛋白原(FIB)与血小板的影响.方法 选取2013年1月至2014年12月于山东省淄博市临淄区人民医院剖宫产分娩的产妇130例,完全随机分为对照组(62例)和观察组(68例).对照组在胎儿娩出后给予卡前列素氨丁三醇注射液250 μg子宫宫体注射,观察组在对照组的基础上联合应用氨甲环酸静脉滴注(1g±5％葡萄糖注射液稀释至0.05 g/ml).比较2组产妇术后2、24h出血量、产后出血发生率、药物应用后子宫收缩持续时间、产后子宫底下降速度、恶露持续时间,治疗前后FIB和血小板水平及不良反应发生情况.结果 观察组术后2、24h出血量、产后出血发生率低于对照组,药物应用后子宫收缩持续时间、产后子宫底下降速度、FIB、血小板计数高于对照组,恶露持续时间低于对照组[(236±50) ml比(352±53) ml、(312±68)ml比(445±64)ml、4.4％ (3/68)比16.1％ (10/62)、(3.2±1.1)h比(1.7±0.4)h、(1.12±0.25) cm/d比(0.58±0.16) cm/d、(3.78±0.25)g/L比(3.13±0.43) g/L、(116±10)×109/L比(102±9)×109/L、(14±5)d比(20±4)d],差异均有统计学意义(均P ＜0.05).治疗过程中,2组均未出现严重不良反应,观察组和对照组不良反应发生率分别为19.1％ (13/68)和19.4％(12/62),组间比较差异无统计学意义(P＞0.05).结论 氨甲环酸联合卡前列素氨丁三醇注射液是剖宫产后出血的一种有效预防方案,能够明显减少术后出血量,降低产后出血发生率,延长子宫收缩时间,促进产后恢复,改善凝血功能,且不良反应轻微.
目的 探討氨甲環痠聯閤卡前列素氨丁三醇註射液對剖宮產後齣血的預防作用及對纖維蛋白原(FIB)與血小闆的影響.方法 選取2013年1月至2014年12月于山東省淄博市臨淄區人民醫院剖宮產分娩的產婦130例,完全隨機分為對照組(62例)和觀察組(68例).對照組在胎兒娩齣後給予卡前列素氨丁三醇註射液250 μg子宮宮體註射,觀察組在對照組的基礎上聯閤應用氨甲環痠靜脈滴註(1g±5％葡萄糖註射液稀釋至0.05 g/ml).比較2組產婦術後2、24h齣血量、產後齣血髮生率、藥物應用後子宮收縮持續時間、產後子宮底下降速度、噁露持續時間,治療前後FIB和血小闆水平及不良反應髮生情況.結果 觀察組術後2、24h齣血量、產後齣血髮生率低于對照組,藥物應用後子宮收縮持續時間、產後子宮底下降速度、FIB、血小闆計數高于對照組,噁露持續時間低于對照組[(236±50) ml比(352±53) ml、(312±68)ml比(445±64)ml、4.4％ (3/68)比16.1％ (10/62)、(3.2±1.1)h比(1.7±0.4)h、(1.12±0.25) cm/d比(0.58±0.16) cm/d、(3.78±0.25)g/L比(3.13±0.43) g/L、(116±10)×109/L比(102±9)×109/L、(14±5)d比(20±4)d],差異均有統計學意義(均P ＜0.05).治療過程中,2組均未齣現嚴重不良反應,觀察組和對照組不良反應髮生率分彆為19.1％ (13/68)和19.4％(12/62),組間比較差異無統計學意義(P＞0.05).結論 氨甲環痠聯閤卡前列素氨丁三醇註射液是剖宮產後齣血的一種有效預防方案,能夠明顯減少術後齣血量,降低產後齣血髮生率,延長子宮收縮時間,促進產後恢複,改善凝血功能,且不良反應輕微.
목적 탐토안갑배산연합잡전렬소안정삼순주사액대부궁산후출혈적예방작용급대섬유단백원(FIB)여혈소판적영향.방법 선취2013년1월지2014년12월우산동성치박시림치구인민의원부궁산분면적산부130례,완전수궤분위대조조(62례)화관찰조(68례).대조조재태인면출후급여잡전렬소안정삼순주사액250 μg자궁궁체주사,관찰조재대조조적기출상연합응용안갑배산정맥적주(1g±5％포도당주사액희석지0.05 g/ml).비교2조산부술후2、24h출혈량、산후출혈발생솔、약물응용후자궁수축지속시간、산후자궁저하강속도、악로지속시간,치료전후FIB화혈소판수평급불량반응발생정황.결과 관찰조술후2、24h출혈량、산후출혈발생솔저우대조조,약물응용후자궁수축지속시간、산후자궁저하강속도、FIB、혈소판계수고우대조조,악로지속시간저우대조조[(236±50) ml비(352±53) ml、(312±68)ml비(445±64)ml、4.4％ (3/68)비16.1％ (10/62)、(3.2±1.1)h비(1.7±0.4)h、(1.12±0.25) cm/d비(0.58±0.16) cm/d、(3.78±0.25)g/L비(3.13±0.43) g/L、(116±10)×109/L비(102±9)×109/L、(14±5)d비(20±4)d],차이균유통계학의의(균P ＜0.05).치료과정중,2조균미출현엄중불량반응,관찰조화대조조불량반응발생솔분별위19.1％ (13/68)화19.4％(12/62),조간비교차이무통계학의의(P＞0.05).결론 안갑배산연합잡전렬소안정삼순주사액시부궁산후출혈적일충유효예방방안,능구명현감소술후출혈량,강저산후출혈발생솔,연장자궁수축시간,촉진산후회복,개선응혈공능,차불량반응경미.
Objective To investigate the curative efficacy of tranexamic acid combined with carboprost tromethamine in fpreventing postpartum hemorrhage and its effects on levels of fibrinogen (FIB) and platelet after cesarean section.Methods Totally 130 delivery women after cesarean section from January 2013 to December 2014 were randomly divided into control group (62 cases) given uterus injection of carboprost tromethamine (250 μg) after delivery and observation group (68 cases) given intravenous drip of tranexamic acid (0.5 g/10 ml,1 g diluted in 5％ glucose injection) in addition to carboprost tromethamine.The blood loss 2 and 24 hours after operation,incidence of postpartum hemorrhage,duration of uterine contraction,lowering speed of uterine bottom after delivery,duration of lochia,levels of FIB and platelet,adverse reactions were compared between the two groups.Results The blood loss 2 and 24 hours after operation was statistically less and the incidence of postpartum hemorrhage was statistically lower in observation group compared with those in control group [(236 ± 50) mlvs (352±53) ml,(312±68) ml vs (445 ±64) ml,4.4％ (3/68) vs 16.1％ (10/62)] (all P＜0.05);observation group had longer duration of uterine contraction,quicker lowering speed of uterine bottom and shorter duration of lochia compared with those in control group [(3.2 ± 1.1) h vs (1.7 ± 0.4) h,(1.12 ±0.25) cm/d vs (0.58 ± 0.16) cm/d,(14 ± 5) d vs (20 ± 4) d] (all P ＜ 0.05);the levels of FIB and platelet were statistically higher in observation group than those in control group [(3.78 ± 0.25) g/L vs (3.13 ±0.43) g/L,(116 ± 10) × 109/L vs (102 ± 9) × 109/L] (both P ＜ 0.05).During treatmeut,no severe adverse reactions occurred in both groups,and the incidence of adverse reactions in the two groups were statistically equal [19.1％ (13/68) vs 19.4％ (12/62)] (P＞0.05).Conclusion Tranexamic acid combined with carboprost tromethamine can prevent postpartum hemorrhage after cesarean section;it can effectively reduce postoperative blood loss,decrease the incidence of postpartum hemorrhage,prolong duration of uterine contraction,promote postpartum recovery and improve coagulation function with few adverse reactions.
