目的 探討產(chǎn)后逐瘀膠囊聯(lián)合卡前列素氨丁三醇注射液治療產(chǎn)后出血的臨床療效。方法 選取天津北大醫(yī)療海洋石油醫(yī)院在2022年1月—2023年12月收治的86例產(chǎn)后出血患者，按治療方案不同將患者分為對(duì)照組和治療組，每組43例。對(duì)照組肌肉注射卡前列素氨丁三醇注射液，1支/次，1次/d。治療組患者在對(duì)照組基礎(chǔ)上口服產(chǎn)后逐瘀膠囊，3粒/次，3次/d。兩組持續(xù)治療2 d。比較兩組的臨床療效、分娩后出血量、子宮復(fù)舊情況、血清指標(biāo)。結(jié)果 治療組患者的治愈率為93.02%，對(duì)照組的治愈率為76.74%，組間差異顯著（P＜0.05）。治療后，治療組分娩后2 h和2～24 h的出血量明顯少于對(duì)照組（P＜0.05）。治療后，兩組的子宮殘留物面積、子宮三徑均小于治療前（P＜0.05）；治療組的子宮殘留物面積、子宮三徑小于對(duì)照組（P＜0.05）。治療后，兩組的抗凝血酶Ⅲ（AT-Ⅲ）顯著升高，纖維蛋白原（FIB）、D-二聚體（D-D）顯著降低（P＜0.05）；治療組的AT-Ⅲ高于對(duì)照組，F(xiàn)IB、D-D低于對(duì)照組（P＜0.05）。結(jié)論 產(chǎn)后逐瘀膠囊聯(lián)合卡前列素氨丁三醇注射液可提高產(chǎn)后出血的臨床療效，降低出血量，促進(jìn)子宮復(fù)舊，調(diào)節(jié)凝血和纖溶功能。

Objective To investigate the clinical effect of Chanhou Zhuyu Capsules combined with Carboprost Tromethamine Injection in treatment of postpartum hemorrhage. Methods Patients (86 cases) with postpartum hemorrhage in Tianjin Peking University Medical Offshore Oil Hospital from January 2022 to December 2023 were randomly divided into control and treatment groups according to different treatment plans, and each group had 43 cases. Patients in the control group were im administered with Carboprost Tromethamine Injection, 1 piece/time, once daily. Patients in the treatment group were po administered with Chanhou Zhuyu Capsules on the basis of the control group, 3 grains/time, three times daily. Patients in two groups were treated for 2 d. The clinical efficacies, postpartum bleeding volume, uterine involution, and serum indicators in two groups were compared. Results The cure rate in the treatment group (93.02%) was significantly higher than 76.74% in the control group, and the difference was significant between groups (P < 0.05). The amounts of blood loss 2 h and 2—24 h after delivery in the treatment group was lower than those in the control group (P < 0.05). After treatment, the area of uterine residue and three diameters of uterus in two groups were lower than those before treatment (P < 0.05), and the area of uterine residue and the uterine diameter of the treatment group were lower than those of the control group (P < 0.05). After treatment, the levels of AT-III in two groups were significantly increased, while the levels of FIB and D-D in two groups were significantly decreased (P < 0.05). The levels of AT-III in the treatment group were higher than those in the control group, while the levels of FIB and D-D in the treatment group were lower than those in the control group (P < 0.05). Conclusion Chanhou Zhuyu Capsules combined with Carboprost Tromethamine Injection has clinical effect in treatment of postpartum hemorrhage, can reduce bleeding volume, promote uterine involution, regulate coagulation and fibrinolysis functions.

R984