氨甲环酸联合马来酸麦角新碱治疗初产妇产后出血的临床疗效

Effect of Tranexamic Acid Combined with Ergotrine Maleate on Puerperal Hemorrhage

【目的】探讨氨甲环酸联合马来酸麦角新碱治疗初产妇产后出血的临床疗效。【方法】选取2021年2月至2022年10月本院收治的197例产后出血的初产妇,按照随机数字表法分为对照组(n=98)和观察组(n=99),对照组给予马来酸麦角新碱治疗,观察组在对照组基础上给予氨甲环酸治疗。比较两组止血情况、药物不良反应情况及凝血功能指标、血液流变学指标、子宫动脉血流动力学指标、外周血细胞因子指标[一氧化氮(NO)、一氧化氮合酶(NOS)]水平。【结果】观察组治疗后2 h、6 h、24 h的出血量及止血时间均少于对照组(P<0.05)。观察组治疗后凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)均少于对照组,纤维原蛋白(FIB)高于对照组(P<0.05);全血黏度、血浆黏度、红细胞比容均高于对照组(P<0.05)。观察组治疗后子宫动脉收缩期峰值流速(PSV)均高于对照组,搏动指数(PI)、阻力指数(RI)均低于对照组(P<0.05)。观察组治疗后NO、NOS均低于对照组(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。【结论】氨甲环酸联合马来酸麦角新碱治疗初产妇产后出血,可减少患者出血量,改善患者凝血功能、血液流变学及子宫动脉血流动力学指标,抑制NO及NOS合成,且安全性良好。

【Objective】To investigate the effect of tranexamic acid combined with ergotrine maleate on puerperal hemorrhage.【Methods】A total of 197 primiparas with postpartum hemorrhage admitted to our hospital from February 2021 to October 2022 were selected as research subjects who were divided into the control group(n=98 cases)and the observation group(n=99 cases)by random number table method.The control group was given ergotrine maleate,while the observation group was given tranexamic acid in addition to the treatment of the control group.Hemostasis,coagulation function,hemorheology index,uterine arterial blood flow dynamics index,peripheral blood cytokine nitric oxide(NO)and nitric oxide synthase(NOS)were compared between the two groups.The adverse drug reactions were compared between the two groups as well.【Results】The blood loss and hemostatic time of the observation group at 2 h,6 h and 24 h after treatment were lower than those in the control group(P<0.05).The prothrombin time(PT),thrombin time(TT)and activated partial thrombin time(APTT)of the observation group after treatment were lower than those of the control group,while the fibrinogen protein(FIB)was higher than that in the control group(P<0.05).The whole blood viscosity,plasma viscosity and erythrocyte volume of the observation group after treatment were higher than those in the control group(P<0.05).The The peak systolic flow velocity(PSV)of the observation group after treatment was higher than that of the control group,while the pulsation index(PI)and resistance index(RI)in the observation group were lower than those in the control group(P<0.05).The levels of NO and NOS in the observation group after treatment were lower than those in the control group(P<0.05).There was no significant difference in the incidence of total adverse reactions between the two groups(P>0.05).【Conclusion】Tranexamic acid combined with ergotrine maleate in the treatment of puerperal hemorrhage can reduce the amount of blood loss,improve the coagulation function,hemorheology and uterine arterial blood flow dynamics of patients with good safety,and inhibit the synthesis of NO and NOS.