氨甲环酸联合缩宫素对剖宫产术后PLT、FIB及Hb水平的影响

Effect of tranexamic acid combined with oxytocin on PLT,FIB and Hb levels after cesare⁃an section

目的研究氨甲环酸联合缩宫素对剖宫产术后血小板计数(PLT)、纤维蛋白原(FIB)、血红蛋白(Hb)水平的影响。方法收集2017年1月至2020年5月本院行剖宫产分娩的86例产妇的临床资料。根据不同预防出血方案,分为单一组(n=41例,缩宫素)与联合组(n=45例,氨甲环酸联合缩宫素),比较两组产后出血发生率、术后出血量、围手术期相关指标、外周血液指标、血液流变学指标及不良反应发生情况。结果联合组剖宫产术后出血发生率(8.89%)显著低于单一组(26.83%),术后2 h、24 h出血量均显著低于单一组,差异均有统计学意义(P<0.05)。与单一组相比,联合组子宫收缩持续时间延长,子宫底下降速度加快,恶露持续时间缩短,差异有统计学意义(P<0.05)。术后24 h两组PLT、FIB水平均较术前上升,Hb水平均较治疗前下降,且联合组上述外周血液指标水平改善程度均显著优于单一组,差异均有统计学意义(P<0.05)。两组各时点高切全血黏度、低切全血黏度、血浆黏滞度及不良反应发生率比较差异均无统计学意义(P>0.05)。结论氨甲环酸联合缩宫素预防剖宫产术后出血效果良好,可改善产妇凝血功能,且不会导致血液流变学指标异常,安全性较高。

Objective To analyze the effect of tranexamic acid combined with oxytocin on plate⁃let count(PLT),fibrinogen(FIB)and hemoglobin(Hb)levels after cesarean section.The clinical data of 86 parturients with cesarean section in our hospital from January 2017 to May 2020 were collected.According to different bleeding prevention programs,they were divided into a single group(n=41 cases,oxytocin)and a combined group(n=45 cases,tranexamic acid+oxytocin).The incidence of postpartum hemorrhage,postoperative blood loss,perioperative related indicators,peripheral blood indicators,hemorheology indicators and adverse reactions were compared between the two groups.Results The incidence of bleeding after cesarean section in the combined group(8.89%)was significantly lower than that in the single group(26.83%).The blood loss 2 h and 24 h after the operation was significantly lower than that of the single group,the differences were statistically significant(P<0.05).Compared with the single group,the duration of uterine contraction in the combined group was prolonged,and the descent rate of uterine fundus was accelerated,and the duration of lo⁃chia was shortened(P<0.05).At 24 hours after operation,the levels of PLT and FIB in the two groups increased compared with those before operation,and the Hb level decreased,and the improvement of the above⁃mentioned peripheral blood index levels in the combined group was significantly better than that in the single group,and the differences were statistically significant(P<0.05).There was no significant difference in the whole blood high shear viscosity,the whole blood medium shear viscosity,the whole blood low shear viscosi ty,plasma viscosity,and the incidence of adverse reactions between the two groups at each time point(P>0.05).Conclusion Tranexamic acid combined with oxytocin has a good effect on preventing bleeding after cesarean section,can improve the coagulation function of the parturient,and will not cause abnormal hemorhe⁃ological indicators,and has high safety.