缩宫素联合伊血安颗粒对剖宫产后出血的疗效

来源:用户上传      作者:谢银凤

　　[摘要] 目的 分析s宫素联合伊血安颗粒治疗剖宫产术后出血的效果及对超声指标的影响。方法 选取2021年1―10月广东省汕头市第二人民医院接收的58例剖宫产术后出血患者为研究对象，按照随机数字表法分为对照组和试验组，每组各29例;对照组患者使用缩宫素治疗，试验组患者使用缩宫素联合伊血安颗粒治疗。比较治疗效果、术后出血量、治疗前后血流峰速（Vmax）、血流量（PBF）和阻力指数（RI）等超声血流动力学指标变化;治疗前后血红蛋白（Hb）、纤维蛋白原（FIB）、血小板计数（PLT）、红细胞压积（HCT）、活化部分凝血酶原时间（APTT）及凝血酶原时间（PT）等凝血功能指标水平及不良反应出现情况。结果 相较于对照组，试验组的治疗总有效率更高（96.55%vs.75.86%），术后12 h、24 h出血量更低，差异有统计学意义（P<0.05）。两组患者治疗前的Vmax、PBF和RI指标比较，差异无统计学意义（P>0.05），治疗后两组的Vmax和PBF明显减小、RI明显增大，且试验组的Vmax和PBF均低于对照组、RI高于对照组（P<0.05）。两组患者治疗前的Hb、FIB、PLT、HCT、APTT及PT指标比较，差异无统计学意义（P>0.05），治疗后两组的Hb、FIB、PLT、HCT水平提高，APTT及PT缩短，且试验组的Hb、FIB、PLT、HCT水平均高于对照组，APTT及PT均短于对照组（P<0.05）。两组患者的血压上升、脉搏增快、头晕及恶心呕吐等不良反应发生率比较，差异无统计学意义（P>0.05）。结论 缩宫素联合伊血安颗粒治疗剖宫产术后出血疗效更佳，可改善血流动力学、凝血功能指标，减少出血量，且不会显著增加不良反应发生，有着较高的安全性，具有推广价值。
　　[关键词] 剖宫产;术后出血;缩宫素;伊血安颗粒;血流动力学;凝血功能
　　[中图分类号] R719.8;R714.46+1 [文献标识码] B [文章编号] 1673-9701（2022）13-0051-04
　　[Abstract] Objective To analyze the efficacy of oxytocin combined Yixuean granules in the treatment of post-cesarean hemorrhage and the effect on ultrasound indexes. Methods A total of 58 patients with post-cesarean hemorrhage admitted to the Second People′s Hospital of Shantou in Guangdong Province from January to October 2021 were selected as study subjects and divided into the control group and the experimental group according to the random number table method， with 29 cases in each group. The control group was treated with oxytocin， while the experimental group was treated with oxytocin + Yixuean granules. The efficacy， postoperative bleeding volume， changes in the levels of ultrasonic hemodynamics indicators such as maximum peak flow velocity （Vmax）， blood flow volume （pulmonary blood flow， PBF） and resistance index （RI）， and changes in the levels of coagulation function indicators such as hemoglobin （Hb）， fibrinogen （FIB）， platelet count （PLT）， hematocrit （HCT）， activated partial thromboplastin time （APTT） and prothrombin time （PT） before and after treatment， as well as the occurrence of adverse reactions （ARs）， were compared between the two groups. Results The overall effective rate of treatment in the experimental group was higher than that in the control group （96.55% vs. 75.86%）， and the postoperative bleeding volume of the experimental group at 12 h and 24 h after surgery was lower than that of the control group， with statistically different differences （P<0.05）. The Vmax， PBF and RI levels in the two groups were similar before treatment （P>0.05）， and Vmax and PBF levels decreased significantly and RI level increased significantly after treatment， and all the indicators in the experimental group were better than those in the control group （P<0.05）. The Hb， FIB， PLT， HCT， APTT and PT levels in the two groups were similar before treatment （P>0.05）， the Hb， FIB， PLT and HCT levels increased and APTT and PT shortened after treatment， and all indicators of the experimental group were better than those of the control group （P<0.05）. In addition， the incidence of ARs such as elevated blood pressure， increased pulse rate， dizziness， nausea and vomiting in the two groups were similar （P>0.05）. Conclusion Oxytocin combined Yixuean granules has sound efficacy in the treatment of post-cesarean hemorrhage， which can improve hemodynamics and coagulation function indicators， reduce bleeding volume， and does not significantly increase the occurrence of ARs， with high safety. Therefore， it is worthy of promotion.

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