摘要
目的：观察参芪化瘀方结合常规西药治疗宫缩乏力型产后出血的临床治疗效果及其对FIB、D-D的影响。方法：选取宫缩乏力型产后出血产妇93例,随机分为对照组及观察组,对照组45例,观察组48例。对照组患者采用子宫肌内注射缩宫素20U,给予米索前列醇600μg嚼碎后舌下含化或经直肠给药。观察组采用参芪化瘀方治疗。比较两组产妇产后2 h及24 h出血量、总输血量;入院时及产后24 h血红细胞（RBC）和血红蛋白（HGB）水平;两组产妇产前和产后2 h的凝血酶原时间（PT）、血浆凝血酶时间（TT）、纤维蛋白原（FIB）、D-二聚体（D-D）。观察两组产妇产前和产后24 h血流动力学指标,收缩压（SBP）、舒张压（DBP）、血氧饱和度（SpO_2）及心率（HR）变化。记录两组孕妇产后不良结局发生情况,比较两组患者的临床疗效。结果：两组比较,观察组产妇产后2 h及24 h的出血量、总输血量均明显少于对照组（P〉0.05）;治疗后对照组产妇生产后2 h的PT及TT与产前比较明显延长（P〈0.05）,两组患者的FIB及D-D与治疗前均显著下降（P〈0.05）;对照组产妇的临床总有效率为73.3%,观察组产妇的临床总有效率93.8%（P〈0.05）,观察组的不良结局明显少于对照组（P〈0.05）。结论：参芪化瘀方结合常规西药治疗宫缩乏力型产后出血具有良好的临床疗效,不良结局少,值得在临床上推广。
Objective： To observe the clinical effect of Shenqi Huayu Recipe combined with conventional western medicine in the treatment of postpartum hemorrhage caused by uterine atony and its influence on FIB and D-D. Methods：Ninety-three cases of uterine atony postpartum hemorrhage were randomly divided into the control group and the observation group,45 cases in the control group and 48 cases in the observation group. The control group was treated with intramuscular injection of oxytocin 20 U with misoprostol 600 g after sublingual or rectal administration. The observation group was treated with Shenqi Huayu Recipe. We compared 2 groups＇ maternal postpartum hemorrhage and the total volume of blood transfusion in 2 h and 24 h; red blood cells（ RBC） and hemoglobin（ HGB） in admission and postpartum 24 h; maternal prenatal and postnatal 2 h prothrombin time（ PT）,thrombin tim（ TT）,fibrinogen（ FIB） and D two dimers（ D-D）. The hemodynamic parameters of 24 h and 2 weeks before and after delivery were observed in H,systolic pressure（ SBP）,diastolic blood pressure（ DBP）,blood oxygen saturation（ SpO_2） and heart rate（ HR）. The adverse events of 2 groups of pregnant women were recorded and the clinical efficacy of the 2 groups was compared. Results： The observation group＇s postpartum hemorrhage and total amount of blood transfusion in 2 h and 24 h were significantly less than those of the control group（ P〈 0. 05）. HGB and RBC were observed after treatment and maternal blood index decreased signifi-cantly compared with those of the control group（ P〈 0. 05）. After treatment,the treatment group＇s 2 h PT and TT prolonged significantly compared with prenatal PT and TT（ P〈 0. 05）. The observation group＇s 2 h PT and TT production and prenatal PT and TT had no significant difference（ P〈 0. 05）. FIB and D-D of 2 groups before treatment were significantly decreased（ P〈 0. 05）,and the observation group＇s maternal rate was significantly lower than that o
作者
李苑瑛
LI Yuanying(Obstetrics and Gynecology Department, First Affiliated Hospital of Henan Medical College, Nanyang 473000 ,Henan,Chin)
出处
《中华中医药学刊》
CAS
北大核心
2018年第4期942-945,共4页
Chinese Archives of Traditional Chinese Medicine
基金
河南省科技攻关项目(102102310282)
