益母草注射液联合缩宫素注射液预防产后出血的疗效研究

Efficacy of Leonurus Injection Combined with Oxytocin Injection in the Prevention of Postpartum Hemorrhage

目的:探讨益母草注射液联合缩宫素注射液预防产后出血的疗效。方法:回顾性选取2017年1月至2018年6月秦皇岛军工医院妇产科收治的围产期妇女134例作为研究对象,按干预方式不同分为对照组和观察组,每组67例。对照组患者仅采用缩宫素注射液治疗。观察组患者根据产后出血预测评估结果分为中危组(n=22)、低危组(n=27)和高危组(n=18);观察组患者分娩后在对照组基础上加用益母草注射液2 ml,于臀大肌肌内注射;高危组患者在胎儿娩出后视出血情况加用益母草注射液2 ml。观察各组患者的产后出血情况、出血量、宫缩强度、凝血功能[凝血酶原时间(PT)、部分凝血活酶时间(APTT)]水平、临床疗效及不良反应发生情况。结果:观察组患者的产后出血发生率为16.41%(11/67),明显低于对照组的34.32%(23/67),差异有统计学意义(P<0.05)。术中,术后2、24 h,观察组患者的平均出血量明显低于对照组,差异均有统计学意义(P<0.05);观察组内各亚组间比较,高危组患者在各时间点的出血量最高。产后10、30及60 min,观察组患者的平均宫缩强度明显高于对照组,差异均有统计学意义(P<0.05);观察组内各亚组间比较,高危组患者在各时间点的宫缩强度较弱。产前、产后3 d,两组患者APTT、PT的差异均无统计学意义(P>0.05);观察组内各亚组间比较,高危组患者的APTT、PT稍延长,但与低、中危组比较的差异无统计学意义(P>0.05)。观察组患者的总有效率为92.54%(62/67),明显高于对照组的77.61%(52/67),差异有统计学意义(P<0.05)。观察组、对照组患者的不良反应发生率分别为17.91%(12/67)、26.87%(18/67),差异无统计学意义(P>0.05)。结论:益母草注射液联合缩宫素注射液预防产后出血的效果较好,能有效降低患者产后出血率,减少出血量;采用益母草注射液干预不同危险程度的患者,可增强宫缩强度,保证凝血功能,减少不良反应,改善预后。

OBJECTIVE:To probe into the efficacy of leonurus injection combined with oxytocin injection in the prevention of postpartum hemorrhage.METHODS:Totally 134 parturients admitted into Qinhuangdao Military Engineering Hospital from Jan.2017 to Jun.2018 were extracted to be divided into the control group and the observation group via different intervention methods,with 67 cases in each group.The control group was treated with oxytocin injection alone,while the observation group were divided into medium-risk group(n=22),low-risk group(n=27)and high-risk group(n=18)according to the results of risk prediction on postpartum hemorrhage.After delivery,the observation group was given 2 ml of leonurus injection for intramuscular injection at gluteus maximus based on the control group;the high-risk group was given 2 ml of leonurus injection according to the bleeding situation after delivery.The postpartum hemorrhage rate,amount of bleeding,intensity of uterine contraction,coagulation function[prothrombin time(PT),activated partial thromboplastin time(APTT)],clinical efficacy and incidence of adverse drug reactions of all groups were observed.RESULTS:The incidence of postpartum hemorrhage of observation group was 16.41%(11/67),which was significantly lower than that of the control group(34.32%,23/67),with statistically significant difference(P<0.05).During the operation,2 h and 24 h after operation,the average amount of bleeding of observation group was significantly lower than that of the control group,with statistically significant difference(P<0.05);in the comparison among observation groups,the amount of bleeding of high-risk group was the highest at each time point.At 10 min,30 min and 60 min after delivery,the average intensity of uterine contraction of observation group was significantly higher than that of the control group,with statistically significant difference(P<0.05);in the comparison among observation groups,the intensity of uterine contraction of high-risk group was weaker at each time point.At before delivery and 3 days after,there were no statistical significance in the difference in APTT and PT levels between two groups(P>0.05);in the comparison among observation groups,the APTT and PT levels of high-risk group was slightly longer,while the differences between low-risk group and medium-risk group had no statistical significance(P>0.05).The total effective rate of observation group was 95.54%(62/67),which was significantly higher than that of the control group(77.61%,52/67),with statistically significant difference(P<0.05).The incidences of adverse drug reactions of observation group and control group were respectively 17.91%(12/67)and 26.87%(18/67),the difference had no statistical significance(P>0.05).CONCLUSIONS:The effect of leonurus injection combined with oxytocin injection in the prevention of postpartum hemorrhage is remarkable,which can significantly decrease postpartum hemorrhage rate and reduce the amount of bleeding;the intervention of leonurus injection on patients at different risk levels can enhance the intensity of uterine contraction,ensure coagulation function,reduce adverse drug reactions and improve prognosis.