氨甲环酸联合缩宫素用于剖宫产产妇分娩后的效果及对产后出血情况、血流动力学的影响

Effect of tranexamic acid combined with oxytocin on parturients after cesarean section and its influences on postpartum hemorrhage and hemodynamics

目的分析氨甲环酸联合缩宫素用于剖宫产产妇分娩后的效果及对产后出血情况、血流动力学的影响。方法选取2020年3月至2022年6月我院收治的102例剖宫产产妇为研究对象,根据随机数字表法将其分为对照组(51例,缩宫素)和研究组(51例,氨甲环酸联合缩宫素)。比较两组的止血效果、血流动力学指标、泌乳情况及不良反应发生情况。结果研究组的产后2、24 h出血量少于对照组,宫缩持续时间长于对照组,子宫底下降速度快于对照组,产后出血率低于对照组,差异具有统计学意义(P<0.05)。术后24 h,研究组的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)短于对照组,纤维蛋白降解产物(FDP)、纤维蛋白原(FIB)水平高于对照组,差异具有统计学意义(P<0.05)。研究组的泌乳启动时间短于对照组,产后1、2 d泌乳量评分高于对照组,差异具有统计学意义(P<0.05)。两组的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论氨甲环酸联合缩宫素能调控剖宫产产妇分娩后机体血流动力学,降低产后出血发生风险,值得推广和应用。

Objective To analyze the effect of tranexamic acid combined with oxytocin on parturients after cesarean section and its influences on postpartum hemorrhage and hemodynamics.Methods A total of 102 parturients with cesarean section admitted in our hospital from March 2020 to June 2022 were selected as the research objects.According to the random number table method,the parturients were divided into control group(51 cases,oxytocin)and study group(51 cases,tranexamic acid combined with oxytocin).The hemostatic effect,hemodynamic indexes,lactation and adverse reactions were compared between the two groups.Results The amount of postpartum hemorrhage at 2 and 24 h after delivery in the study group was less than that in the control group,and the duration of uterine contraction was longer than that in the control group,and the descending speed of uterine fundus was faster than that in the control group,and the rate of postpartum hemorrhage was lower than that in the control group,and the differences were statistically significant(P<0.05).At 24 h after operation,the prothrombin time(PT)and activated partial thromboplastin time(APTT)in the study group were shorter than those in the control group,and the levels of fibrin degradation product(FDP)and fibrinogen(FIB)were higher than those in the control group,and the differences were statistically significant(P<0.05).The starting time of lactation in the study group was shorter than that in the control group,and the score of lactation volume at 1 and 2 d after delivery was higher than that in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Tranexamic acid combined with oxytocin can regulate the hemodynamics of parturients after cesarean section,and reduce the risk of postpartum hemorrhage,which is worthy of promotion and application.