氨甲环酸联合麦角新碱预防剖宫产产后出血的效果

Effects of Tranexamic acid combined with Ergometrine in prevention of postpartum hemorrhage after cesarean section

目的:探讨氨甲环酸联合麦角新碱预防剖宫产产后出血的效果。方法:回顾性分析2021年3月至2023年4月在该院分娩的78例剖宫产产妇的临床资料,依据预防产后出血方法不同将其分为对照组和观察组各39例。对照组采用马来酸麦角新碱注射液预防产后出血,观察组在其基础上联用氨甲环酸注射液。比较两组临床疗效、产后出血量、产后出血发生率、产后不同时间宫底高度、产前和产后凝血功能指标[凝血酶时间(TT)、凝血酶原时间(PT)、D-二聚体(D-D)、纤维蛋白原(FIB)]水平,以及不良反应发生率。结果:观察组总有效率为97.44%(38/39),高于对照组的79.49%(31/39),差异有统计学意义(P<0.05);观察组产后出血发生率为5.13%(2/39),低于对照组的20.51%(8/39),差异有统计学意义(P<0.05);观察组产后1、2、6、24 h出血量均少于对照组,产后3、5 d的宫底高度均低于对照组,产后PT、TT值均小于对照组,FIB、D-D水平均高于对照组,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)。结论:氨甲环酸联合麦角新碱预防剖宫产产后出血效果显著,可改善产妇凝血功能,减少产后出血量,降低产后出血发生率,促进产后子宫恢复,效果优于单用麦角新碱。

Objective:To investigate effects of Tranexamic acid combined with Ergometrine in prevention of postpartum hemorrhage after cesarean section.Methods:The clinical data of 78 cesarean section women who gave birth in the hospital from March 2021 to April 2023 were retrospectively analyzed.According to the different prevention methods of postpartum hemorrhage,they were divided into control group and observation group,39 cases in each group.The control group was treated with Ergometrine maleate injection to prevent postpartum hemorrhage,while the observation group was treated with Tranexamic acid injection on the basis of that of the control group.The clinical efficacy,the postpartum hemorrhage volume,the incidence of postpartum hemorrhage,the uterine fundus height at different postpartum time,the prenatal and postpartum coagulation function indexes[thrombin time(TT),prothrombin time(PT),D-dimer(D-D)and fibrinogen(FIB)]levels,and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of the observation group was 97.44%(38/39),which was higher than 79.49%(31/39)of the control group,and the difference was statistically significant(P<0.05).The incidence of postpartum hemorrhage in the observation group was 5.13%(2/39),which was lower than 20.51%(8/39)in the control group,and the difference was statistically significant(P<0.05).The hemorrhage volume levels 1,2,6 and 24 h after delivery in the observation group were less than those in the control group,the uterine fundus height levels 3 and 5 d after delivery were lower than those in the control group,the values of postpartum PT and TT were lower than those in the control group,the levels of FIB and D-D were higher than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Tranexamic acid combined with Ergometrine has a significant effect on preventing postpartum hemorrhage after cesarean section,which can improve the maternal coagulation function,reduce the postpartum hemorrhage,reduce the incidence of postpartum hemorrhage,and promote the postpartum uterine recovery.Moreover,it is superior to single Ergometrine treatment.