目的 探討注射用矛頭蝮蛇血凝酶聯(lián)合氨甲苯酸治療剖宮產(chǎn)術(shù)后出血的臨床療效。方法 選取2020年7月—2023年6月首都醫(yī)科大學(xué)附屬北京婦產(chǎn)醫(yī)院收治的126例剖宮產(chǎn)產(chǎn)后出血患者，按隨機(jī)數(shù)字表法將患者分為對照組和治療組，每組各63例。對照組靜脈滴注氨甲苯酸氯化鈉注射液，0.2 g/次，2次/d。在對照組基礎(chǔ)上，治療組靜脈注射注射用矛頭蝮蛇血凝酶，每次將1單位溶于10 mL生理鹽水，2次/d。兩組患者均治療1 d。觀察兩組患者臨床療效，比較治療前后兩組患者出血情況，簡式抑郁–焦慮–壓力量表（DASS-21）評分，及全血血紅蛋白（Hb）、血小板計數(shù)（PLT）和血小板壓積（PCT）水平。結(jié)果 治療后，治療組總有效率（98.41%）顯著高于對照組（87.30%，P＜0.05）。治療后，治療組患者0.5、2、24 h的出血量較對照組明顯降低（P＜0.05）。治療后，兩組患者DASS-21中各子量表評分及量表總分較治療前明顯下降（P＜0.05），且治療后治療組顯著低于對照組（P＜0.05）。治療后，兩組全血Hb、PLT、PCT水平均顯著上升（P＜0.05），且以治療組患者升高更明顯（P＜0.05）。結(jié)論 注射用矛頭蝮蛇血凝酶聯(lián)合氨甲苯酸治療剖宮產(chǎn)術(shù)后出血療效確切，能在較好的安全性基礎(chǔ)上，進(jìn)一步增強(qiáng)止血效果，有效減少出血量，糾正凝血異常，促進(jìn)產(chǎn)婦身心恢復(fù)。

Objective To investigate the clinical efficacy of hemocoagulase bothrops atrox combined with aminomethylbenzoic acid in treatment of postpartum bleeding after cesarean section. Methods A total of 126 patients with postpartum hemorrhage during cesarean section admitted to Beijing Obstetrics and Gynecology Hospital Affiliated to Capital Medical University from July 2020 to June 2023 were selected and divided into control group and treatment group according to random number table method, with 63 cases in each group. Patients in the control group were iv administered with Aminomethylbenzoic Acid and Sodium Chloride Injection, 0.2 g/time, twice daily. Patients in the treatment group were iv administered with Hemocoagulase Bothrops Atrox for injection on the basis of the control group, 1 unit each time was dissolved in 10 mL normal saline, twice daily. Patients in two groups were treated for 1 d. After treatment, the clinical evaluations were evaluated, and the bleeding, DASS-21 scores, and the levels of whole blood Hb, PLT, and PCT in two groups before and after treatment were compared. Results After treatment, the total effective rate in the treatment group (98.41%) was significantly higher than that in the control group (87.30%, P < 0.05). After treatment, the amount of bleeding at 0.5, 2, and 24 h in the treatment group was significantly lower than that in the control group (P < 0.05). After treatment, the scores of each subscale and the total score of the scale in DASS-21 in two groups were significantly decreased compared with those before treatment (P < 0.05), and the treatment group was significantly lower than that in the control group (P < 0.05). After treatment, the whole blood Hb, PLT, and PCT levels were significantly increased in two groups (P < 0.05), and the increase was more significant in the treatment group (P < 0.05). Conclusion Hemocoagulase Bothrops Atrox for injection combined with aminomethylbenzoic acid has a definite effect on post-cesarean section bleeding. It can further enhance the hemostatic effect on the basis of good safety, effectively reduce the amount of bleeding, correct coagulation abnormalities, and promote maternal physical and mental recovery.

R984

北京市醫(yī)院管理中心“青苗”計劃專項經(jīng)費資助（QML20181401）