缩宫素联合马来酸麦角新碱治疗经产妇宫缩乏力性产后出血的效果

Effect of Oxytocin Combined with Ergometrine Maleate in the Treatment of Postpartum Hemorrhage Caused by Uterine Atony in Multipara

目的:分析缩宫素联合马来酸麦角新碱治疗经产妇宫缩乏力性产后出血的效果。方法:回顾性分析2020年1月—2022年1月北京市丰台区妇幼保健院收治的80例宫缩乏力性产后出血经产妇的临床资料。根据不同治疗方法将其分为对照组和研究组,各40例。对照组实施缩宫素治疗,研究组实施缩宫素联合马来酸麦角新碱治疗。比较两组出血情况及住院时间、临床疗效、不良反应,用药前、用药24 h凝血功能及收缩压,恶露情况。结果:研究组用药2 h、24 h出血量少于对照组,住院时间短于对照组,差异有统计学意义(P<0.05)。研究组总有效率高于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。用药24 h,两组凝血酶原时间(prothrombin time,PT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、凝血酶时间(thrombin time,TT)均短于用药前,且观察组均短于对照组,两组纤维蛋白原(fibrinogen,FIB)均高于用药前,且观察组均高于对照组;两组国际标准化比值(international normalized ratio,INR)均低于用药前,且观察组均低于对照组,差异有统计学意义(P<0.05)。两组用药前、用药24 h收缩压比较差异无统计学意义(P>0.05)。研究组血性恶露持续时间、恶露完全消失时间均显著短于对照组,差异有统计学意义(P<0.05)。结论:缩宫素联合马来酸麦角新碱治疗能改善宫缩乏力性产后出血经产妇的凝血功能指标,进而起到有效止血的作用,且安全性较好,有利于患者的子宫复旧。

Objective:To analyze the effect of Oxytocin combined with Ergometrine Maleate in the treatment of postpartum hemorrhage caused by uterine atony in multipara.Method:The clinical data of 80 multipara with postpartum hemorrhage caused by uterine atony admitted to Beijing Fengtai Maternal and Child Health Hospital from January 2020 to January 2022 were retrospective analyzed.According to different treatment methods,the patients were divided into control group and study group,40 cases in each group.The control group was treated with Oxytocin,and the study group was treated with Oxytocin combined with Ergometrine Maleate.The bleeding situation and hospital stay,clinical efficacy,adverse reactions,coagulation function,systolic blood pressure before and 24 h of medication and lochia condition were compared between the two groups.Result:The blood loss volume of the study group at 2 h and 24 h of medication were less than those of the control group,and the hospital stay was shorter than that of the control group,the differences were statistically significant(P<0.05).The total effective rate of the study group was higher than that of the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).At 24 h of medication,prothrombin time(PT),activated partial thromboplastin time(APTT),and thrombin time(TT)were shorter than those before medication,and those of the observation group were shorter than those of the control group,and fibrinogen(FIB)were higher than those before medication,and that of the observation group was higher than that of the control group;international normalized ratio(INR)of two groups were lower than those before medication,and that of observation group was lower than that of the control group,the differences were statistically significant(P<0.05).There were no significant differences in systolic blood pressure between the two groups before medication and 24 h of medication(P>0.05).The bloody lochia duration and complete disappearance time of lochia of the study group were significantly shorter than those of the control group,and the differences were statistically significant(P<0.05).Conclusion:The treatment of Oxytocin combined with Ergometrine Maleate can improve the coagulation function index of multipara with postpartum hemorrhage caused by uterine atony,and then play an effective role in hemostasis,with better safety,which is conducive to uterine involution of the patients.