益气缩宫汤联合卡前列素氨丁三醇治疗产后宫缩乏力出血临床观察及安全性评价

Clinical Observation and Safety Evaluation of Yiqi Suogong Decoction Combined with Carprostol Tromethamine in Treatment of Postpartum Hemorrhage Due to Uterine Inertia

目的观察益气缩宫汤联合卡前列素氨丁三醇治疗产后宫缩乏力出血的临床疗效及安全性评价。方法选取产后宫缩乏力出血患者86例,随机分为两组,每组43例。对照组患者子宫肌内注射卡前列素氨丁三醇注射液,观察组采用益气缩宫汤联合卡前列素氨丁三醇治疗。比较两组产妇产后2、24 h出血量、及产后24 h血红蛋白(Hb)下降值;比较生产前后两组的凝血指标水平;比较两组患者临床疗效、产后恢复指标及治疗过程中出现的不良反应。结果观察组总有效率95.3%(41/43),对照组总有效率83.7%(36/43),差异有统计学意义(P<0.05);观察组患者产后2 h、24 h的出血量及Hb下降值均明显低于对照组,差异有统计学意义(P<0.05)。生产后观察组的凝血指标(PT、TT、APTT、FIB及D-D)及血流动力学(SBP、DBP及MAP)明显低于生产前(P<0.05),血Ca2+水平及HR显著高于生产前(P<0.05),并且观察组的凝血指标及血流动力学的变化幅度显著高于对照组(P<0.05)。观察组的子宫收缩时间显著高于对照组(P<0.05),恶露持续时间、宫腔深度显著低于对照组(P<0.05),晚期再出血率、产褥期感染率及宫腔积液产妇例数明显低于对照组(P<0.05)。结论益气缩宫汤联合卡前列素氨丁三醇治疗产后宫缩乏力出血具有良好的临床疗效,安全性高,值得在临床上推广。

Objective To observe the clinical efficacy and safety evaluation of Yiqi Suoggong Decoction combined with carprostol tromethamine in the treatment of postpartum hemorrhage due to uterine inertia.Methods Eighty-six patients with postpartum hemorrhage due to uterine inertia were randomly divided into two groups,with 43 in each group.The control group was treated with intrauterine injection of carboprost tromethamine,and the observation group was treated with Yiqi Suogong Decoction combined with carboprost tromethamine.The postpartumhemorrhage volumes at 2 h and 24 h and the postpartumdecrease of hemoglobin(Hb)at 24 h were compared between the two groups.The blood coagulation indexes of the two groups before and after delivery were compared.The clinical efficacy,postpartum recovery index and adverse reactions during treatment were compared between the two groups.Results The total effective rate was 95.3%(41/43)in the observation group and 83.7%(36/43)in the control group,and the difference was statistically significant(P<0.05).The hemorrhage volume and the decrease of Hb in the observation group 2 and 24 hours after delivery were significantly lower than those in the control group(P<0.05).The postoperative coagulation indexes(PT,TT,APTT,FIB and DD)and hemodynamics(SBP,DBP and MAP)were significantly lower than those before delivery(P<0.05),and the levels of Ca2+and HR in blood were significantly higher than those before delivery(P<0.05).The changes of coagulation index and hemodynamics in the observation group were significantly higher than those in the control group(P<0.05).The uterine contraction time of the observation group was significantly higher than that of the control group(P<0.05).The duration of lochia and the depth of the uterine cavity of the observation group were significantly lower than those of the control group(P<0.05).The rate of late rebleeding,puerperal infection rate and the number of puerperal women with uterine effusion in the observation group was significantly lower than those in the control group(P<0.05).Conclusion Yiqi Suogong Decoction combined with carprostol tromethamine for the treatment of postpartum hemorrhage due to uterine inertia has good clinical efficacy and high safety,which is worthy of clinical promotion.