马来酸麦角新碱联合子宫动脉栓塞术治疗产时出血疗效及对患者血清PAF、PagT影响

Clinical efficacy of ergometrine maleate combined with uterine artery embolization for treating women with intrapartum hemorrhage and its influences on their expression levels of serum platelet activating factor and platelet aggregation test

目的:探究马来酸麦角新碱联合子宫动脉栓塞术(UAE)治疗产时出血的临床疗效及对产妇血清血小板激活因子(PAF)、血小板聚集试验(PagT)表达的影响。方法:选取2020年2月-2022年6月在本院行UAE治疗的产时出血患者70例,随机分为对照组(35例)和观察组(35例),均行UAE,术后对照组给予缩宫素治疗,观察组给予马来酸麦角新碱治疗。视觉模拟评分法(VAS)评估疼痛程度,记录阴道出血量,术后月经周期、恶露暴露时间及转经时间,检测血清PAF、PagT水平,统计临床疗效及不良反应发生率。结果:观察组术后24、48、72h VAS评分低于对照组,阴道出血量(221.37±22.58 ml、135.48±13.69 ml、56.74±5.72 ml)均低于对照组(221.37±22.58 ml、168.32±17.25 ml、75.63±7.61 ml),术后月经周期(29.4±3.01d)、恶露暴露时间(28.6±2.9d)及转经时间(90.2±9.1d)均短于对照组(32.5±3.3d、35.5±3.6d、97.5±9.9d),两组治疗后血清PagT、PAF水平均升高且观察组升高幅度大于对照组(均P<0.05);观察组总有效率(94.3%)高于对照组(71.4%),不良反应发生率(2.9%)低于对照组(22.9%)(均P<0.05)。结论:马来酸麦角新碱联合UAE治疗产时出血可更有效减少出血量,调节血清PAF、PagT水平,减轻患者疼痛,促进恢复,且用药安全有效。

Objective: To investigate the clinical efficacy of ergometrine maleate combined with uterine artery embolization(UAE) for treating women with intrapartum hemorrhage, and to study its influences on the expression levels of serum platelet activating factor(PAF) and platelet aggregation test(PagT) of these women. Methods: 70 women with intrapartum hemorrhage who had accepted UAE were selected and were randomly divided into control group(35 cases) and experimental group(35 cases). The women in the control group were given oxytocin after UAE, and the women in the experimental group were given ergometrine maleate after UAE. The pain degree of the women in the two groups was evaluated by visual analogue scale(VAS). The vaginal bleeding volume, the postoperative menstrual cycle, the lochia exposure time, and the time of menstrual recovery of the women in the two groups were recorded. The levels of serum PAF and PagT of the women in the two groups were detected. The clinical efficacy and the incidence of adverse reactions of the women in the two groups were counted. Results: The VAS scores of the women in the experimental group at 24, 48 and 72 hours after operation were significantly lower than those of the women in the control group. The amount of vaginal bleeding(221.37±22.58 ml, 135.48±13.69 ml, or 56.74±5.72 ml) of the women in the experimental group at 24, 48, or 72 hours after operation was significantly lower than that(221.37±22.58 ml, 168.32±17.25ml,or 75.63±7.61ml)of the women in the control group.The postoperative menstrual cycle time(29.4±3.01d),the lochia time(28.6±2.9d),and the menstrual recovery time(90.2±9.1d)of the women in the experimental group were significantly shorter than those(32.5±3.3d,35.5±3.6d,and 97.5±9.9d)of the women in the control group.The levels of serum PagT and PAF of the women in both groups after treatment had increased significantly,and the change degree of the women in the experimental group were significantly greater than those of the women in the control group(P<0.05).The total(94.3%)effective rate of the women in the experimental group was significantly higher than that(71.4%)of the women in the control group,and the incidence of adverse reactions(2.9%)of the women in experimental group was significantly lower than that(22.9%)of the women in the control group(all P<0.05).Conclusion:Ergometrine maleate combined with UAE for treating women with intrapartum hemorrhage can effectively reduce their amount of bleeding,regulate their levels of serum PAF and PagT,relieve their pain,and promote their recovery,and which has good safety and effectiveness of medicine.