复方芦丁片联合缩宫素治疗宫缩乏力性产后出血的临床研究
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摘要
目的探讨复方芦丁片联合缩宫素治疗宫缩乏力性产后出血的临床效果。方法选取2013年2月—2018年2月南阳医学高等专科学校第二附属医院收治的82例宫缩乏力性产后出血,随机分为对照组和治疗组,每组各41例。对照组经臀部肌肉注射缩宫素注射液,以10 U为首剂,而后20 U加入生理盐水500 m L中充分稀释后静脉滴注,滴速以80 m U/min为宜,具体滴速可根据每位患者实际反应进行调整。治疗组在对照组基础上口服复方芦丁片,2片/次,3次/d。两组均连续治疗3 d。观察两组的临床疗效,比较两组出血量、止血时间。比较两组治疗前后宫底高度、血栓素(TX)B2、肿瘤坏死因子(TNF)-α、白介素(IL)-6、一氧化氮(NO)水平的变化情况。结果治疗后,对照组和治疗组的总有效率分别为85.37%、100.00%,两组比较差异具有统计学意义(P<0.05)。治疗组治疗0.5、2、24 h出血量均显著低于对照组同期,治疗组止血时间显著短于对照组,两组比较差异具有统计学意义(P<0.05)。两组治疗1、3 d时宫底高度均显著降低,同组治疗前后比较差异有统计学意义(P<0.05);治疗组治疗1、3 d时宫底高度显著低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组血清TXB2水平较治疗前均显著增高,NO、TNF-α、IL-6水平均显著降低,同组治疗前后比较差异有统计学意义(P<0.05);治疗后,治疗组TXB2水平显著高于对照组,NO、TNF-α、IL-6水平低于对照组,两组比较差异具有统计学意义(P<0.05)。结论复方芦丁片联合缩宫素治疗宫缩乏力性产后出血具有较好的临床疗效,能明显减少出血量,促进子宫复旧,改善微循环,具有一定的临床推广应用价值。
Objective To investigate the clinical effect of Compound Rutin Tablets combined with oxytocin in treatment of postpartum hemorrhage caused by uterine inertia. Methods Patients(82 cases) with postpartum hemorrhage caused by uterine inertia in the Second Affiliated Hospital Affiliated to Nanyang Medical College were randomly divided into control(41 cases) and treatment(41 cases) groups. Patients in the control group were im administered with Oxytocin Injection in hip muscle, starting with 10 U. Then 20 U added into normal saline500 m L, and patients were iv administered with Oxytocin Injection, and the dripping rate was 80 m U/min, the specific dripping rate was adjusted according to the actual reaction of each patient. Patients in the treatment group were po administered with Compound Rutin Tablets on the basis of the control group, 2 tablets/time, three times daily. Patients in two groups were treated for 3 d. After treatment, the clinical efficacy was evaluated, and the bleeding volume and hemostasis time in the two groups were compared. The changes of the uterus bottom height, the TXB2, TNF-α, IL-6, and NO in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment group were 85.37% and100.00%, and there were differences between two groups(P < 0.05). After treatment, the bleeding volume in the treatment group for 0.5, 2 and 24 h was significantly lower than that in the control group, and the hemostasis time was significantly shorter than that in the control group, and there were differences between two groups(P < 0.05). The uterus bottom heights in two groups were decreased significantly in both groups at 1 and 3 d, and there were differences in the same group(P < 0.05). After treatment, the uterus bottom height in the treatment group was significantly lower than that in the control group at 1 and 3 days, and there were differences between two groups(P < 0.05). After treatment, TXB2 in two groups was significantly increased, but NO, TNF-α, and IL-6 were significantly decreased, and there were differences in the same group(P < 0.05). After treatment, TXB2 in the treatment group was higher than that in the control group, but NO, TNF-α, and IL-6 was lower than those in the control group, and there were differences between two groups(P < 0.05). Conclusion Compound Rutin Tablets combined with oxytocin has significant clinical effect in treatment of postpartum hemorrhage caused by uterine inertia, and can significantly reduce the bleeding amount, also can promote the uterine rehabilitation and improve microcirculation, which has a certain clinical application value.
Objective To investigate the clinical effect of Compound Rutin Tablets combined with oxytocin in treatment of postpartum hemorrhage caused by uterine inertia. Methods Patients(82 cases) with postpartum hemorrhage caused by uterine inertia in the Second Affiliated Hospital Affiliated to Nanyang Medical College were randomly divided into control(41 cases) and treatment(41 cases) groups. Patients in the control group were im administered with Oxytocin Injection in hip muscle, starting with 10 U. Then 20 U added into normal saline500 m L, and patients were iv administered with Oxytocin Injection, and the dripping rate was 80 m U/min, the specific dripping rate was adjusted according to the actual reaction of each patient. Patients in the treatment group were po administered with Compound Rutin Tablets on the basis of the control group, 2 tablets/time, three times daily. Patients in two groups were treated for 3 d. After treatment, the clinical efficacy was evaluated, and the bleeding volume and hemostasis time in the two groups were compared. The changes of the uterus bottom height, the TXB2, TNF-α, IL-6, and NO in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment group were 85.37% and100.00%, and there were differences between two groups(P < 0.05). After treatment, the bleeding volume in the treatment group for 0.5, 2 and 24 h was significantly lower than that in the control group, and the hemostasis time was significantly shorter than that in the control group, and there were differences between two groups(P < 0.05). The uterus bottom heights in two groups were decreased significantly in both groups at 1 and 3 d, and there were differences in the same group(P < 0.05). After treatment, the uterus bottom height in the treatment group was significantly lower than that in the control group at 1 and 3 days, and there were differences between two groups(P < 0.05). After treatment, TXB2 in two groups was significantly increased, but NO, TNF-α, and IL-6 were significantly decreased, and there were differences in the same group(P < 0.05). After treatment, TXB2 in the treatment group was higher than that in the control group, but NO, TNF-α, and IL-6 was lower than those in the control group, and there were differences between two groups(P < 0.05). Conclusion Compound Rutin Tablets combined with oxytocin has significant clinical effect in treatment of postpartum hemorrhage caused by uterine inertia, and can significantly reduce the bleeding amount, also can promote the uterine rehabilitation and improve microcirculation, which has a certain clinical application value.
引文
[1]李会荣.产后出血53例临床分析[J].山西医药杂志:下半月刊,2013,42(9):1038-1039.
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[10]陈业星.益母草注射液联合复方芦丁片治疗产后出血的临床效果[J].实用妇科内分泌杂志:电子版,2017,4(2):117,120.
[11]段芙蓉.复方芦丁片联合欣母沛治疗产后出血的临床疗效观察[J].临床医学研究与实践,2016,1(12):7-8.
[12]唐丽霞,刘萍,李文蕾,等.前列腺素类物质与宫缩乏力性产后出血的相关性[J].中国实用妇科与产科杂志,2012,28(1):53-55.
[13]孙晓峰,张建平,温岩.NO、NOS与宫缩乏力性产后出血关系的研究[J].中国妇幼保健,2006,21(10):1333-1336.
[14]刘楼,孙丽洲,许建娟.分娩前后凝血与纤溶指标的变化及与炎症因子的相关性[J].中国妇产科临床杂志,2017,18(5):456-457.
[2]张琴,刘会兰,张丽君,等.产后出血109例临床分析及产后出血病因分析[J].现代生物医学进展,2012,12(22):4349-4350.
[3]张玉林,赵纯全.缩宫素在妇产科临床的应用研究进展[J].中国药房,2014,25(44):4219-4222.
[4]中华人民共和国卫生部药典委员会.中华人民共和国卫生部药品标准(化学药品及制剂第一册)WS1-68(B)-89[M].北京:中华人民共和国卫生部,1989:89.
[5]曹泽毅.中华妇产科学[M].:第3版.北京:人民卫生出版社,2014:420-422.
[6]国家中医药管理局.中华人民共和国中医药行业标准《中医病证诊断疗效标准》(ZY/T001.1-94)[M].南京:南京大学出版社,1994:246-247.
[7]段春月.对宫缩乏力性产后出血高危因素的重新认识[J].现代中西医结合杂志,2010,19(23):2901-2902.
[8]姜红.宫缩乏力性产后出血治疗研究进展[J].首都食品与医药,2016,23(6):18-19.
[9]刘倩,钱德明,刘群丽,等.缩宫素及其类似物的研究进展[J].药物分析杂志,2011,31(3):609-613.
[10]陈业星.益母草注射液联合复方芦丁片治疗产后出血的临床效果[J].实用妇科内分泌杂志:电子版,2017,4(2):117,120.
[11]段芙蓉.复方芦丁片联合欣母沛治疗产后出血的临床疗效观察[J].临床医学研究与实践,2016,1(12):7-8.
[12]唐丽霞,刘萍,李文蕾,等.前列腺素类物质与宫缩乏力性产后出血的相关性[J].中国实用妇科与产科杂志,2012,28(1):53-55.
[13]孙晓峰,张建平,温岩.NO、NOS与宫缩乏力性产后出血关系的研究[J].中国妇幼保健,2006,21(10):1333-1336.
[14]刘楼,孙丽洲,许建娟.分娩前后凝血与纤溶指标的变化及与炎症因子的相关性[J].中国妇产科临床杂志,2017,18(5):456-457.