目的 探討益母草顆粒聯(lián)合卡貝縮宮素治療宮縮乏力性產(chǎn)后出血的臨床療效。方法 選取2021年1月-2022年3月天津市中心婦產(chǎn)科醫(yī)院收治的96例宮縮乏力性產(chǎn)后出血患者,按隨機(jī)數(shù)字表法將所有患者分為對(duì)照組和治療組,每組各48例。對(duì)照組靜脈注射卡貝縮宮素注射液,單次100 μg。治療組在對(duì)照組基礎(chǔ)上口服益母草顆粒,1袋/次,2次/d,開水沖服。兩組用藥24 h后觀察療效。比較兩組用藥后2、12、24 h的出血量和止血時(shí)間。比較治療前后兩組癥狀自評(píng)量表(SCL-90)評(píng)分、血紅蛋白(HGB)及凝血與纖溶指標(biāo)水平。結(jié)果 治療后,治療組總有效率是100.00%,顯著高于對(duì)照組的87.50%(P<0.05)。治療組患者用藥后2、12、24 h的出血量均顯著少于同期對(duì)照組(P<0.05)。治療組止血時(shí)間較對(duì)照組顯著縮短(P<0.05)。治療后,兩組SCL-90評(píng)分、HGB水平均顯著降低(P<0.05);且治療后,治療組SCL-90評(píng)分顯著低于對(duì)照組,HGB水平則顯著高于對(duì)照組(P<0.05)。治療后,兩組凝血酶原時(shí)間(PT)、活化部分凝血活酶時(shí)間(APTT)均顯著縮短, D-二聚體(D-D)、纖維蛋白降解產(chǎn)物(FDP)均顯著降低,抗凝血酶Ⅲ(AT-Ⅲ)均顯著升高(P<0.05),均以治療組改善更顯著(P<0.05)。結(jié)論 益母草顆粒聯(lián)合卡貝縮宮素治療子宮收縮乏力性產(chǎn)后出血可獲得良好療效,能有效增強(qiáng)止血效果,促進(jìn)凝血功能恢復(fù)及心理狀態(tài)改善,值得臨床推廣應(yīng)用。

Objective To explore the clinical efficacy of Yimucao Granules combined with carbetocin in treatment of postpartum hemorrhage caused by uterine fatigue. Methods A total of 96 patients with postpartum hemorrhage caused by uterine fatigue admitted to Tianjin Central Obstetrics and Gynecology Hospital from January 2021 to March 2022 were selected and divided into control group and treatment group according to random number table method, with 48 patients in each group. Patients in the control group were iv administered with Carbetocin Injection, 100 μg at a time. Patients in the treatment group were po administered with Yimucao Granules with boiling water on the basis of the control group, 1 bag/time, twice daily. The two groups were treated for 24 h and the curative effect was observed. The blood loss and hemostatic time of 2, 12 and 24 h after treatment were compared between the two groups. The score of SCL-90, hemoglobin (HGB), coagulation and fibrinolysis index were compared between two groups before and after treatment. Results After treatment, the total effective rate of the treatment group was 100.00%, which was significantly higher than that of the control group (87.50%, P < 0.05). The amount of blood loss in the treatment group was significantly lower than that in the control group at 2, 12 and 24 h after treatment (P < 0.05). The hemostatic time in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, SCL-90 score and HGB level were significantly decreased in both groups (P < 0.05). After treatment, SCL-90 score in the treatment group was significantly lower than that in the control group, and HGB level was significantly higher than that in the control group (P < 0.05). After treatment, PT and APTT were significantly shortened, D-D and FDP were significantly decreased, AT-Ⅲ was significantly increased in both groups (P < 0.05), and the improvement was more significant in the treatment group (P < 0.05). Conclusion Yimucao Granules combined with carbetocin in treatment of postpartum hemorrhage caused by uterine fatigue can obtain good curative effect, effectively enhance the hemostatic effect, promote the recovery of coagulation function and improve the psychological state, which is worthy of clinical application.

R984

天津市衛(wèi)生健康科研項(xiàng)目資助項(xiàng)目(ZC20142)；天津市醫(yī)學(xué)重點(diǎn)學(xué)科(?？?建設(shè)項(xiàng)目資助項(xiàng)目(TJYXZDXK-043A)