马来酸麦角新碱联合米索前列醇对宫缩乏力性产后出血产妇凝血功能的影响

The Effect of Ergometrine Maleate Combined with Misoprostol on Coagulation Function of Puerperae with Postpartum Hemorrhage due to Uterine atony

目的探讨对宫缩乏力性产后出血产妇予马来酸麦角新碱联合米索前列醇治疗的效果及对患者凝血功能的影响。方法随机选择该院2020年1—12月收治宫缩乏力性产后出血产妇80例,随机分组,对照组(n=40)给予米索前列醇治疗,观察组(n=40)则在对照组基础上联用马来酸麦角新碱治疗,对比两组治疗效果,监测治疗前后凝血功能指标D-二聚体(D-D)、凝血酶原时间(PT)、凝血酶时间(TT)、纤维蛋白原(Fbg)水平评价产妇凝血功能,并监测治疗前后去甲肾上腺素(NE)与丙二醛(MDA)水平评估产妇应激反应。结果观察组总有效率较对照组高(97.50%vs 80.00%),差异有统计学意义(χ^(2)=4.507,P<0.05)。治疗后观察组PT、TT水平分别为(15.62±2.41)s、(19.32±2.21)s较对照组高;D-D、Fbg水平分别为(178.52±30.04)μg/mL、(2.32±0.70)g/L,较对照组低;治疗后观察组NE、MDA水平为(131.57±20.44)ng/mL、(4.25±1.10)μmol/L,较对照组低,差异有统计学意义(t=3.966、4.871、2.580、3.575、5.684、17.210,P<0.05)。结论对宫缩乏力性产后出血者予马来酸麦角新碱联合米索前列醇治疗疗效可靠,能够改善产妇凝血功能,且可减轻其应激反应,值得推广。

Objective To investigate the effect of ergometrine maleate combined with misoprostol in the treatment of puerperae with postpartum hemorrhage caused by uterine atony and its effect on coagulation function.Methods A total of 80 puerperae with postpartum hemorrhage caused by uterine atony were randomly selected in the hospital from January to December 2020.The patients were randomly divided into groups,the control group(n=40)was treated with misoprostol,and the observation group(n=40)was treated with ergometrine maleate on the basis of the control group.The treatment effects of the two groups were compared.The levels of coagulation function indexes D-dimer(D-D),prothrombin time(PT),thrombin time(TT)and fibrinogen(Fbg)were monitored before and after treatment to evaluate maternal coagulation function.The levels of norepinephrine(NE)and malondialdehyde(MDA)were monitored before and after treatment to evaluate maternal stress response.Results The total effective rate of the observation group was higher than that of the control group(97.50%vs 80.00%),and the difference was statistically significant(χ^(2)=4.507,P<0.05).After treatment,the levels of PT and TT in the observation group were(15.62±2.41)s and(19.32±2.21)s,respectively,higher than those in the control group.The levels of D-D and Fbg were(178.52±30.04)μg/mL and(2.32±0.70)g/L,respectively,which were lower than those in the control group.After treatment,the levels of NE and MDA in the observation group were(131.57±20.44)ng/mL,(4.25±1.10)μmol/L,which were lower than those in the control group,and the difference was statistically significant(t=3.966,4.871,2.580,3.575,5.684,17.210,P<0.05).Conclusion Ergometrine maleate combined with misoprostol has a reliable curative effect in the treatment of postpartum hemorrhage caused by uterine atony.