缩宫素、马来酸麦角新碱联合氨甲环酸注射液对产后出血高危剖宫产产妇的影响OA
Effects of Oxytocin and Methylergometrine Maleate Combined with Tranexamic Acid Injection on Cesarean Section Parturients at High Risk of Postpartum Hemorrhage
目的 探讨缩宫素、马来酸麦角新碱联合氨甲环酸注射液对产后出血高危剖宫产产妇出血量、凝血/纤溶相关指标及子宫复旧的影响.方法 选取 2024 年 11 月至 2025 年 3 月于南阳油田总医院行剖宫产手术的产妇 100 例,采用随机数字表法分为对照组和实验组,每组50例.对照组采用缩宫素注射液联合马来酸麦角新碱注射液预防产后出血;实验组在对照组治疗基础上加用氨甲环酸注射液静脉滴注.比较两组术中出血量和术后至产后 24 h 阴道出血量、实验室指标、子宫复旧指标、康复指标及不良反应发生情况.结果 实验组术中出血量和术后至产后 24 h 阴道出血量均低于对照组,产后 1 h、24 h 血红蛋白、纤维蛋白原(FIB)水平均高于同期对照组,凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)及 D-二聚体(D-D)水平均低于同期对照组(P＜0.05).实验组产后子宫下降速度大于对照组,住院时间和泌乳启动时间均短于对照组,产后 3 min 内宫缩累计时长长于对照组(P＜0.05).两组不良反应发生情况比较无统计学差异(P＞0.05).结论 在缩宫素联合马来酸麦角新碱基础上加用氨甲环酸,可能有助于减少具有产后出血高危因素剖宫产产妇围术期出血量,改善血红蛋白及部分凝血/纤溶相关实验室指标,并促进产后早期恢复,且未增加本研究观察范围内的不良反应发生率.
Objective To investigate the effects of oxytocin and ergometrine maleate combined with tranexamic acid injection on blood loss,coagulation/fibrinolysis-related indicators,and uterine involution in women at high risk of postpartum hemorrhage undergoing cesarean section.Methods A total of 100 women who underwent cesarean section at Nanyang Oilfield General Hospital from November 2024 to March 2025 were selected and divided into a control group and an experimental group using a random number table method,with 50 women in each group.The control group received oxytocin injection combined with ergometrine maleate injection to prevent postpartum hemorrhage.The experimental group received intravenous infusion of tranexamic acid injection in addition to the treatment administered to the control group.Intraoperative blood loss,vaginal blood loss from after surgery to 24 h postpartum,laboratory indicators,uterine involution indicators,recovery indicators,and adverse reactions were compared between the two groups.Results Intraoperative blood loss and vaginal blood loss from after surgery to 24 h postpartum in the experimental group were lower than those in the control group.At 1 h and 24 h postpartum,hemoglobin and fibrinogen(FIB)levels in the experimental group were higher than those in the control group at the same time points,whereas thrombin time(TT),prothrombin time(PT),activated partial thromboplastin time(APTT),and D-dimer(D-D)levels were lower than those in the control group at the same time points(P＜0.05).The rate of postpartum uterine descent in the experimental group was greater than that in the control group,the length of hospital stay and time to initiation of lactation were shorter than those in the control group,and the cumulative duration of uterine contractions within 3 min postpartum was longer than that in the control group(P＜0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion Adding tranexamic acid to oxytocin combined with ergometrine maleate may help reduce perioperative blood loss in women with high-risk factors for postpartum hemorrhage undergoing cesarean section,improve hemoglobin and some coagulation/fibrinolysis-related laboratory indicators,and promote early postpartum recovery,without increasing the incidence of adverse reactions within the observation scope of this study.
李哲;鲁果;白录增;赵娜;汤冠莉
南阳油田总医院 产科,河南 南阳 473132南阳油田总医院 产科,河南 南阳 473132南阳油田总医院 产科,河南 南阳 473132南阳油田总医院 检验科,河南 南阳 473132南阳油田总医院 产科,河南 南阳 473132
剖宫产产后出血氨甲环酸缩宫素马来酸麦角新碱凝血功能
cesarean sectionpostpartum hemorrhagetranexamic acidoxytocinmethylergometrine maleatecoagulation function
《临床研究》 2026 (6)
94-97,4
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