世界中医药

目的:探讨益母草注射液联合格丹及欣母沛在前置胎盘剖宫产术后出血中的应用及安全性分析。方法:选取2015年7月至2016年10月于我院产科被诊断为前置胎盘及择期行剖宫产分娩的产妇46例,根据产后止血方式的不同分为观察组和对照组,各23例。观察组待胎儿产出后立即注射益母草注射液2 mL+欣母沛250 μg于子宫肌层,格丹50 mL冲洗宫腔并保留1 min,对照组注射益母草注射液2 mL+欣母沛250 μg于子宫肌层,以0.9%氯化钠注射液50 mL冲洗宫腔并保留1 min。观察2组手术后出血情况及止血效果;检测2组手术前后血红蛋白(Hb)、红细胞计数(RBC)及血浆凝血酶原时间(PT)及凝血酶时间(TT)等凝血相关指标;术后随访42 d,统计产后并发症发生率、不良反应发生率及子宫复旧情况。结果:观察组显效率91.30%,对照组显效率73.91%,2组间显效率差异无统计学意义(P>0.05)。观察组术中出血量、术后2 h、24 h阴道出血量、术中输血量均显著低于对照组,差异有统计学意义(P<0.05或P<0.01)。观察组并发症发生率低于对照组,子宫复旧率高于对照组(P<0.05);不良反应发生率2组间比较,差异无统计学意义(P>0.05)。与术前比较,术后24 h 2组Hb水平均显著降低(P<0.05或P<0.01),RBC及PT、TT无明显变化(P>0.05);术后24 h观察组RBC、Hb水平均显著高于对照组,差异有统计学意义(P<0.01),PT、TT2组间比较,差异无统计学意义(P>0.05)。术后随访2组新生儿生长发育均良好。结论:益母草注射液联合格丹及欣母沛在前置胎盘剖宫产术后出血中具有较好的止血效果,降低产妇并发症发生率,且术后子宫恢复良好。

English Summary:

To observe the efficacy and safety of leonurus injection combined with Gedan and Xinmu Pei in hemorrhage of placenta previa cesarean section. Methods:Forty-six patients diagnosed as placenta previa who need elective cesarean delivery in our hospital admitted from July 2015 to October 2016 were collected. According to different ways of postpartum hemostasis, 46 patients were divided into experimental group and control group, with 23 cases in each group. After surgery, the experimental group were immediately injected with leonurus injection 2 mL+Xinmu Pei 250 μg. Gedan 50 mL was given to rinse the uterine cavity for 1 min. The control group was injected with leonurus injection 2 mL+Xinmu Pei 250 μg, and the uterine cavity was rinsed for 1 min with 0.9% sodium chloride injection 50 mL. The bleeding status and hemostasis effect were observed in 2 groups. The levels of hemoglobin (Hb), erythrocyte count (RBC) and plasma prothrombin time (PT) and thrombin time (TT) were measured before and after operation. The patients were followed up for 42 days to collect the incidence of postpartum complications, adverse reactions and uterine recovery situation. Results:The amount of intra-operative blood loss, postoperative 2 h, 24 h vaginal bleeding, intra-operative blood transfusion were significantly lower in the experimental group than those of the control group (P<0.05 or P<0.01). The incidence of complications was lower in the experimental group than that of the control group (P<0.05), and the recovery rate of uterus in the experimental group was higher than that of the control group (P<0.05). However, there was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Compared with presurgery and 24 h after surgery, Hb levels in the two groups were significantly reduced (P<0.05 or P<0.01), while the levels of RBC and PT, TT had no significant change (P>0.05). However, 24 h after operation, the levels of RBC and Hb in experimental group were significantly higher than those of the control group, and the difference was statistically significant (P<0.01), while PT, TT in the two groups had no significant difference (P>0.05). During follow-up, infants were all healthy and in sound status. Conclusion:Leonurus injection combined with Gedan and Xinmu Pei have obvious effect in treating hemorrhage of placenta previa cesarean section, can reduce the incidence of maternal complications and can improve the uterus after operation.

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