加味复方生化汤联合缩宫素对产后胎盘胎膜小部分残留患者产后出血量、子宫复旧及残留物变化的临床疗效观察

Clinical Efficacy of Modified Fufang Shenghua Decoction(加味复方生化汤)Combined with Oxytocin on Postpartum Hemorrhage,Uterine Involution and Residual Changes in Patients with Small Part of Placenta and Fetal Membrane Remains after Delivery

目的探究观察加味复方生化汤联合缩宫素对产后胎盘胎膜小部分残留患者产后出血量、子宫复旧程度及残留物变化的临床疗效情况。方法回顾性选取2019年1月—2021年12月医院收治的160例产后胎盘胎膜小部分残留患者为研究对象,按照患者治疗意愿分为观察组和对照组各80例,其中对照组患者采取常规缩宫素治疗,观察组患者在对照组的基础上联合使用加味复方生化汤治疗,两组均连续治疗3 d,观察记录两组产妇产后出血量、子宫复旧程度(子宫三径变化情况)、残留物面积大小的变化情况、中医证候积分和临床疗效。结果两组患者均得到了一定的治疗,其中观察组患者产后2 h及产后24 h出血量均少于对照组;两组患者的子宫三径均较治疗前显著降低,其中观察组患者较对照组改善程度更高;观察组患者的子宫底下降速度显著高于对照组;观察组患者宫内残留物面积明显较对照组缩小,治疗后两组患者的中医证候总积分均有所下降,其中观察组患者治疗后总积分显著低于对照组;观察组患者的治疗总有效率显著高于对照组,不良反应及并发症情况显著低于对照组,差异对比均具有统计学意义(P<0.05)。结论加味复方生化汤联合缩宫素对产后胎盘胎膜小部分残留患者的临床疗效显著,能降低产后出血量,利于患者子宫复旧和残留物排出,值得临床进一步推广和深入研究。

Objective To investigate the clinical effect of Modified Fufang Shenghua Decoction(加味复方生化汤)combined with oxytocin on postpartum hemorrhage volume,uterine involution and residual changes in patients with small part of placenta and fetal membrane remains after delivery.Methods From January 2019 to December 2021,160 patients who were admitted to the hospital from January 2019 to December 2021 were retrospectively selected and divided into the observation group and the control group with 80 cases in each.The control group was treated with conventional oxytocin,and the observation group was treated with Modified Fufang Shenghua Decoction on the basis of the control group.Both groups were treated for 3 days continuously.The postpartum hemorrhage volume,hemostasis time,changes of uterine cavity tissue residues,degree of uterine involution(changes in three uterine diameters),changes in the size of residues,TCM syndrome scores and clinical efficacy were measured in the group.Results Both groups received certain treatment.The bleeding volume of the patients in the observation group was less than that in the control group at 2 and 24 hours after delivery.The three diameters of the uterus in the two groups were significantly lower than those before treatment,and those in the observation group were improved more obviously compared with those of the control group.The rate of uterine fundus descending in the observation group was significantly higher than that in the control group.The area of intrauterine residues in the observation group was significantly smaller than that in the control group,and the total scores of TCM syndromes in the two groups decreased after treatment.The total score after treatment in the observation group was signifi-cantly lower than that in the control group.The total effective rate of the observation group was significantly higher than that in the control group,and the adverse reactions and complications were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Modified Fufang Shenghua Decoction combined with oxytocin has a significant clinical effect on patients small part of placenta and fetal membrane remains after delivery,and can reduce the amount of postpartum hemorrhage,facilitate the uterine involution and residual discharge,and is worthy of further clinical promotion and in-depth research.