目的 探討安坤顆粒聯(lián)合卡前列甲酯栓治療產(chǎn)后出血的臨床療效。方法 選擇2017年2月—2019年10月在天津市第一中心醫(yī)院進(jìn)行治療的106例產(chǎn)后出血患者，根據(jù)用藥差別分為對照組和治療組，每組各53例。對照組給予卡前列甲酯栓，戴無菌手套后將卡前列甲酯栓1 mg放入陰道，貼附于陰道前壁下1/3處，約2 min，1次/d；治療組在對照組基礎(chǔ)上口服安坤顆粒，10 g/次，2次/d。兩組均經(jīng)7 d治療。觀察兩組的臨床療效，比較兩組治療2 h、24 h出血量及止血時間，凝血指標(biāo)和子宮血流動力學(xué)指標(biāo)。結(jié)果 治療后，治療組總有效率98.11%，顯著高于對照組的84.91%（P<0.05）。經(jīng)治療，治療組治療2 h、24 h出血量均顯著少于對照組，且止血時間明顯短于對照組（P<0.05）。經(jīng)治療，兩組血清凝血酶原時間（PT）、凝血酶時間（TT）、活化部分凝血酶原時間（APTT）均較治療前降低，而纖維蛋白原（FIB）增高（P<0.05）；治療后，治療組凝血指標(biāo)改善優(yōu)于對照組（P<0.05）。經(jīng)治療，兩組子宮動脈收縮期血流速度（PSV）顯著升高，但阻力指數(shù)（RI）、搏動指數(shù)（PI）均明顯降低（P<0.05）；治療后，治療組子宮血流動力學(xué)指標(biāo)改善優(yōu)于對照組（P<0.05）。結(jié)論 安坤顆粒聯(lián)合卡前列甲酯栓治療產(chǎn)后出血的效果良好，有利于促進(jìn)子宮收縮，改善機體凝血功能，具有很好的臨床應(yīng)用價值。

Objective To investigate the clinical efficacy of Ankun Granules combined with Carboprost Methylate Suppositories in treatment of postpartum hemorrhage. Methods A total of 106 cases of postpartum hemorrhage patients treated in Tianjin First Central Hospital from February 2017 to October 2019 were selected and divided into control group and treatment group according to the difference of medication, with 53 cases in each group. Patients in the control group were administered with Carboprost Methylate Suppositories, after wearing sterile gloves, put 1 mg Carboprost Methylate Suppositories into the vagina and attach it to the lower 1/3 of the anterior vaginal wall for about 2 min, once daily. Patients in the treatment group were po administered with Ankun Granules on the basis of the control group, 10 g/time, twice daily. Both groups were treated for 7 d. The clinical efficacy of the two groups was observed, and the blood loss after 2 h and 24 h treatment, hemostatic time, coagulation indexes and uterine hemodynamics indexes were compared between the two groups. Results After treatment, the total effective rate of treatment group was 98.11%, which was significantly higher than that of control group (84.91%) (P < 0.05). After treatment, the blood loss of 2 h and 24 h after treatment in the treatment group was significantly less than that in the control group, and the hemostatic time was significantly shorter than that in the control group (P < 0.05). After treatment, the serum prothrombin time (PT), thrombin time (TT) and activated partial prothrombin time (APTT) in two groups were decreased compared with those before treatment, while the serum fibrinogen (FIB) was increased (P < 0.05). After treatment, the improvement of coagulation index in treatment group was better than that in control group (P < 0.05). After treatment, uterine artery systolic blood flow velocity (PSV) was significantly increased, but resistance index (RI) and pulse index (PI) were significantly decreased in both groups (P < 0.05). After treatment, the improvement of uterine hemodynamics in the treatment group was better than that in the control group (P < 0.05). Conclusion Ankun Granules combined with Carboprost Methylate Suppositories has good effect in treatment of postpartum hemorrhage, and is beneficial to promote uterine contraction and improve the body's coagulation function, which has a good clinical application value.

R984