益母草注射液联合格丹在前置胎盘剖宫产术后出血中的应用及安全性分析
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摘要
目的:观察益母草注射液联合格丹在前置胎盘剖宫产术后出血中的应用价值及安全性。方法:选取2015年12月至2017年8月重庆市红十字医院收治的前置胎盘择期行剖宫术的孕妇64例作为研究对象,随机分为对照组和观察组,每组32例。术前2组患者均纠正贫血,均行腰椎-硬膜外麻醉,胎儿娩出后,对照组给予缩宫素静脉滴注,观察组在对照组的基础上给予益母草肌内注射联合格丹静脉滴注,观察并比较2组患者的出血情况、实验室相关指标、不良反应、预后及疗效。结果:观察组的显效率为90. 63%,对照组的显效率为71. 11%,差异有统计学意义(P <0. 05);观察组患者的术中出血量、术后2 h出血量、术后24 h出血量和术中输血量均少于对照组,差异有统计学意义(P <0. 05);术后24 h观察组的血红蛋白(Hb)和红细胞计数均高于对照组,差异有统计学意义(P <0. 05);术后24 h 2组凝血酶原时间(PT)及凝血酶时间(TT)比较,差异无统计学意义(P> 0. 05);观察组患者并发症发生率显著低于对照组,差异有统计学意义(P <0. 05),子宫复旧率显著高于对照组,差异有统计学意义(P <0. 05); 2组不良反应发生率比较,差异无统计学意义(P>0. 05)。结论:在使用缩宫素的基础上,益母草注射液联合格丹用于前置胎盘剖宫产术后,止血效果显著,并发症发生率低,子宫恢复较好且不影响机体的凝血系统,具有较高的疗效和安全性。
Objective: To investigate the application and safety analysis of Leonurus injection combined with Gedan in hemorrhage of placenta previa cesarean section. Methods: A total of 64 pregnant women with placenta previa admitted into Chongqing Red Cross Hospital from December 2015 to August 2017 were selected and randomly divided into a control group( n = 32) and an observation group( n = 32). All the patients were treated with correction of anaemiat and lumbar-epidural anesthesia before surgery.The control group was given ocytocin instillation,while the observation group was given Leonurus injection combined with Gedan instillation. The amount of blood loss,laboratory indicators,adverse reactions,prognosis and efficacy were observed and compared between the 2 groups. Results: The explicit efficiency was 90. 63% in the observation group and 71. 11% in the control group,with statistical significance between the 2 groups( P < 0. 05). The amount of intraoperative blood loss,2 h postoperative blood loss,24 h postoperative blood loss and intraoperative blood transfusion in the observation group were all less than those in the control group( P < 0. 05). The levels of 24 h postoperative Hb and RBC in the observation group were higher than those in the control group( P < 0. 05). There was no significant difference in the 24 h postoperative coagulation function indexes( PT and TT) between the 2 groups( P > 0. 05). The incidence of complications in the observation group was significantly lower than that in the control group( P < 0. 05),and the rate of uterine involution was significantly higher than that in the control group( P < 0. 05). There was no significant difference in the incidence of adverse reactions between the 2 groups( P > 0. 05). Conclusion: On the basis of the use of oxytocin,Leonurus injection combined with Gedan has significant hemostatic effects,significantly reduce the incidence of complications,promote uterine involution with high efficacy and safety without affecting the body's coagulation system in hemorrhage of placenta previa cesarean section.
Objective: To investigate the application and safety analysis of Leonurus injection combined with Gedan in hemorrhage of placenta previa cesarean section. Methods: A total of 64 pregnant women with placenta previa admitted into Chongqing Red Cross Hospital from December 2015 to August 2017 were selected and randomly divided into a control group( n = 32) and an observation group( n = 32). All the patients were treated with correction of anaemiat and lumbar-epidural anesthesia before surgery.The control group was given ocytocin instillation,while the observation group was given Leonurus injection combined with Gedan instillation. The amount of blood loss,laboratory indicators,adverse reactions,prognosis and efficacy were observed and compared between the 2 groups. Results: The explicit efficiency was 90. 63% in the observation group and 71. 11% in the control group,with statistical significance between the 2 groups( P < 0. 05). The amount of intraoperative blood loss,2 h postoperative blood loss,24 h postoperative blood loss and intraoperative blood transfusion in the observation group were all less than those in the control group( P < 0. 05). The levels of 24 h postoperative Hb and RBC in the observation group were higher than those in the control group( P < 0. 05). There was no significant difference in the 24 h postoperative coagulation function indexes( PT and TT) between the 2 groups( P > 0. 05). The incidence of complications in the observation group was significantly lower than that in the control group( P < 0. 05),and the rate of uterine involution was significantly higher than that in the control group( P < 0. 05). There was no significant difference in the incidence of adverse reactions between the 2 groups( P > 0. 05). Conclusion: On the basis of the use of oxytocin,Leonurus injection combined with Gedan has significant hemostatic effects,significantly reduce the incidence of complications,promote uterine involution with high efficacy and safety without affecting the body's coagulation system in hemorrhage of placenta previa cesarean section.
引文
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[3]赵敏,万欣,王艳,等.产前MRI检查对妊娠晚期胎盘植入分级诊断的价值[J].青岛大学学报:医学版,2018,54(3):359-361,366.
[4]段艳芳,张学玲,赵明阳,等.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[J].世界中医药,2017,12(3):602-605.
[5]杨兴爽,熊亮.益母草注射液联合卡前列素氨丁三醇预防剖宫产后出血的疗效及对患者FIB,D-二聚体水平的影响[J].中国实验方剂学杂志,2015,21(18):159-162.
[6]郭玲,赵国华,王秀芳.益母草针剂用于剖宫产术止血的效果分析[J].浙江创伤外科,2015,20(2):343-344.
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[9]王智慧.前置胎盘患者产后出血的高危因素及预防措施[J].中国妇幼保健,2017,32(23):5830-5832.
[10]侯纪湘,张芙蓉.益母草注射液预防非凶险性前置胎盘剖宫产术中及术后出血临床研究[J].陕西中医,2017,38(5):623-624.
[11]薛露,刘晨,丁安伟,等.侧柏炭黄酮类成分群对干酵母致血热复合出血模型大鼠的止血作用研究[J].中国医院药学杂志,2016,36(17):1486-1491.
[12]张杨,樊晓旭,柴淑丽,等.见血青总生物碱凝血活性的研究[J].四川大学学报:自然科学版,2017,54(4):870-873.
[13]徐浩,黄兴锐,蒋元斌,等.卡络磺钠用于下肢骨科大手术止血80例疗效及安全性评价[J].中国药业,2015,24(5):29-30.
[14]张艳丽.胃镜下卡络磺钠氯化钠注射液冲洗治疗消化性溃疡出血的效果观察[J].河南医学研究,2018,27(9):1685-1686.
[15]杨德湘,杨莉,王沣,等.不同药物联合卡络磺钠对支气管扩张伴咯血中的临床疗效分析[J].河北医学,2018,24(5):873-876.
[16]刘会芹,赵润果,王芳,等.产后出血相关危险因素分析与治疗方法比较[J].河北医药,2018,40(5):748-751.
[17]张雪,宋玉琴,杨雨婷,等.益母草活血化瘀化学成分与药理作用研究进展[J].药物评价研究,2015,38(2):214-217.
[18]周尹轶凡,李益萍,高俊杰,等.活血化瘀类中药抗血小板作用机制研究进展[J].中成药,2018,40(3):659-662.
[19]毛益申,石家齐,朱明宇.益母草水苏碱药理作用的研究进展[J].微循环学杂志,2017,27(1):65-69.
[2]Milovanov AP,Bushtarev AV,Fokina TV.[Features of cytotrophoblast invasion in complete placenta previa and increta][J]. Arkh Patol,2017,79(6):30-35.
[3]赵敏,万欣,王艳,等.产前MRI检查对妊娠晚期胎盘植入分级诊断的价值[J].青岛大学学报:医学版,2018,54(3):359-361,366.
[4]段艳芳,张学玲,赵明阳,等.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[J].世界中医药,2017,12(3):602-605.
[5]杨兴爽,熊亮.益母草注射液联合卡前列素氨丁三醇预防剖宫产后出血的疗效及对患者FIB,D-二聚体水平的影响[J].中国实验方剂学杂志,2015,21(18):159-162.
[6]郭玲,赵国华,王秀芳.益母草针剂用于剖宫产术止血的效果分析[J].浙江创伤外科,2015,20(2):343-344.
[7]徐国华.不同类型凶险性前置胎盘产妇的临床特点及剖宫产结局[J].中国妇幼保健,2018,33(9):1986-1988.
[8]梁冬儒,张红花,陈晓玲.前置胎盘剖宫产患者产后出血危险因素分析[J].中国当代医药,2018,25(10):108-110.
[9]王智慧.前置胎盘患者产后出血的高危因素及预防措施[J].中国妇幼保健,2017,32(23):5830-5832.
[10]侯纪湘,张芙蓉.益母草注射液预防非凶险性前置胎盘剖宫产术中及术后出血临床研究[J].陕西中医,2017,38(5):623-624.
[11]薛露,刘晨,丁安伟,等.侧柏炭黄酮类成分群对干酵母致血热复合出血模型大鼠的止血作用研究[J].中国医院药学杂志,2016,36(17):1486-1491.
[12]张杨,樊晓旭,柴淑丽,等.见血青总生物碱凝血活性的研究[J].四川大学学报:自然科学版,2017,54(4):870-873.
[13]徐浩,黄兴锐,蒋元斌,等.卡络磺钠用于下肢骨科大手术止血80例疗效及安全性评价[J].中国药业,2015,24(5):29-30.
[14]张艳丽.胃镜下卡络磺钠氯化钠注射液冲洗治疗消化性溃疡出血的效果观察[J].河南医学研究,2018,27(9):1685-1686.
[15]杨德湘,杨莉,王沣,等.不同药物联合卡络磺钠对支气管扩张伴咯血中的临床疗效分析[J].河北医学,2018,24(5):873-876.
[16]刘会芹,赵润果,王芳,等.产后出血相关危险因素分析与治疗方法比较[J].河北医药,2018,40(5):748-751.
[17]张雪,宋玉琴,杨雨婷,等.益母草活血化瘀化学成分与药理作用研究进展[J].药物评价研究,2015,38(2):214-217.
[18]周尹轶凡,李益萍,高俊杰,等.活血化瘀类中药抗血小板作用机制研究进展[J].中成药,2018,40(3):659-662.
[19]毛益申,石家齐,朱明宇.益母草水苏碱药理作用的研究进展[J].微循环学杂志,2017,27(1):65-69.