目的 探討葆宮止血顆粒聯(lián)合卡貝縮宮素注射液治療產(chǎn)后出血的臨床療效。方法 選取2021年5月—2024年5月在衡水市第二人民醫(yī)院就診的136例產(chǎn)后出血患者，以隨機(jī)數(shù)字表法分為對(duì)照組和治療組，每組各68例。對(duì)照組一次性注射1支卡貝縮宮素注射液。治療組在對(duì)照組基礎(chǔ)上口服葆宮止血顆粒，2次/d，1袋/次。14 d為1個(gè)周期，連續(xù)治療2個(gè)周期。比較兩組的治療效果、超聲指標(biāo)、出血和惡露情況、血清指標(biāo)。結(jié)果 治療后，治療組的治愈率為97.06%，對(duì)照組的治愈率為88.24%，組間差異顯著（P＜0.05）。治療后，兩組的子宮殘留物面積明顯降低，子宮下降高度明顯升高（P＜0.05）；治療組的子宮殘留物面積小于對(duì)照組，子宮下降高度高于對(duì)照組（P＜0.05）。治療組持續(xù)出血時(shí)間、持續(xù)惡露時(shí)間均短于對(duì)照組（P＜0.05）。治療后，兩組的血清血小板反應(yīng)蛋白1（THBS-1）、D-二聚體（D-D）水平降低，血清抗凝血酶Ⅲ（AT-Ⅲ）水平升高（P＜0.05）；治療組的血清THBS-1、D-D水平低于對(duì)照組，血清AT-Ⅲ水平高于對(duì)照組（P＜0.05）。結(jié)論 葆宮止血顆粒聯(lián)合卡貝縮宮素可提高產(chǎn)后出血的臨床療效，縮短持續(xù)出血時(shí)間，改善子宮狀態(tài)，可能與調(diào)節(jié)凝血功能有關(guān)。

Objective To explore the clinical efficacy of Baogong Zhixue Granules combined with Carbetocin Injection in treatment of postpartum hemorrhage. Methods 136 Patients with postpartum hemorrhage in The Second People's Hospital of Hengshui from May 2021 to May 2024 were divided into control and treatment groups using a random number table method, with 68 patients in each group. Patients in the control group received a one-time injection of Carbetocin Injection. On the basis of the control group, patients in the treatment group took Baogong Zhixue Granules orally, twice daily, 1 bag/time, with 14 d as a course of treatment, and 2 consecutive courses of treatment. The clinical efficacy, ultrasound indicators, bleeding and lochia status, and serum indicators were compared between two groups. Results The cure rate of the treatment group was 97.06%, the cure rate of the control group was 88.24%, and the difference between groups was significant (P < 0.05). After treatment, the area of uterine residue in both groups was significantly reduced, but the height of uterine descent was significantly increased (P < 0.05). After treatment, the uterine residual area of the treatment group was lower than that of the control group, but the uterine descent height was higher than that of the control group (P < 0.05). The continuous bleeding time and continuous lochia time of patients in the treatment group were shorter than those in the control group (P < 0.05). The serum levels of THBS-1 and D-dimer in both groups after treatment were decreased, but AT-Ⅲ was increased (P < 0.05). After treatment, the serum levels of THBS-1 and D-dimer in the treatment group were lower than those in the control group, but AT-Ⅲ were higher than those in the control group (P < 0.05). Conclusion Baogong Zhixue Granules combined with Carbetocin Injection can improve the efficacy of postpartum hemorrhage, further reduce the duration of bleeding and improve the state of the uterus, which may be related to the regulation of coagulation function.

R984

衡水市科技計(jì)劃項(xiàng)目（2019014004Z）