止血环酸用于减少分娩出血量的临床研究

为评价止血环酸用于减少分娩出血量的有效性和安全性 ,将 1 2 0例阴道分娩的初产妇随机分为止血环酸组 (A组 :止血环酸 +催产素 )、止血芳酸组 (B组 :止血芳酸 +催产素 )和催产素组 (C组 :催产素 ) ,分别观察 3组第 3产程和第 4产程出血量 ,并分别于产前 (第 1产程 )、产后 3 0min和产后 2h检测血纤维蛋白原 (FBG)及D 二聚体 (D dimer)。结果 :① 3组间第 4产程出血量有非常显著差异 (P <0 .0 1 ) ,总出血量有显著差异 (P <0 .0 5 ) ,A组少于C组。②各组间血纤维蛋白原无统计学差异 (P >0 .0 5 )。各组间D dimer有非常显著差异 (P <0 .0 0 1 ) :A组产后 2h高于产前 (P <0 .0 5 ) ,但与产后 3 0min无差异 ;B组产后 3 0min及产后 2h无差异 ,但均高于产前 (P <0 .0 5 ) ;C组产后 2h高于产后 3 0min(P <0 .0 5 ) ,明显高于产前 (P <0 .0 1 ) ,且高于A组产后 2h(P <0 .0 5 )。③ 3组均未出现异常变化 ,无血栓发生。结果提示 :阴道分娩后 ,在使用宫缩剂的基础上 ,适当使用抗纤溶药物可以抑制D dimer浓度的上升 ,减少产后出血量

Clinical Study of Antifibrinolytics on Decrement of Postpartum Blood Loss

To investigate the effect and safety of antifibrinolytics on decrement of postpartum blood loss. One hundred and twenty cases of primipara of vaginal delivery were randomly divided into tranexa mic acid group(Group A: pitocin+tranexamic acid), aminomethylbenzoic acid group(Group B: pitocin+aminomethylbenzoic acid)and pitocin group(Group C: pitocin). The postpartum blood loss was collected and measured carefully within the third stage of labor and forth stage of labor. Fibrinogen and D dimer were examined during antepartum(first stage of labor), half an hour postpartum and 2 hours postpartum. Result: ①The postpartum blood loss during the forth stage of labor in Group A was significantly lower than that in Group C(P<0.01), the total postpartum blood loss of Group A was significantly lower than Group C(P< 0.05). ②Fibrinogen among groups and at different times was not statistically different(P >0.05). D dimer was significantly different(P<0.001). In the Group A, D dimer of 2 hours postpartum was significantly higher than that of antepartum(P<0.05), but was not statistically significant with that of half an hour postpartum; in Group B, D dimer of half an hour and 2 h of postpartum was all significantly higher than that of antepartum(P<0.05); in the Group C, D dimer of 2 hours postpartum was higher than that of half an hour postpartum(P<0.05), and was significantly higher than that of antepartum(P<0.01), and was higher than that of 2 hours postpartum in Group A(P<0.05). ③No thromboembolism appeared in any of the three groups. Conclusion:Based on pitocin, proper antifibrinolytics can depress the rise of D dimer and decrease postpartum blood loss.