氨甲环酸联合垂体后叶素治疗难治性产后出血的临床研究

目的研究氨甲环酸注射液联合垂体后叶注射液治疗难治性产后出血的临床疗效。方法选取2016年12月—2019年12月在洛阳东方医院治疗的70例难治性产后出血患者,将所有患者随机分为对照组和治疗组,每组各35例。对照组患者静脉滴注垂体后叶注射液,6 U溶于5%葡萄糖注射液500 mL中,控制滴速为0.02～0.04 U/min。治疗组患者在对照组基础上缓慢静脉滴注氨甲环酸注射液,1 g溶于5%葡萄糖注射液500 mL中。观察两组临床疗效,比较两组的出血量、止血时间和恶露持续时间、血液学指标D-二聚体(D-D)、血红蛋白(Hb)、血浆纤维蛋白原(FIB)和血清因子一氧化氮合酶(NOS)和一氧化氮(NO)、水平。结果治疗后,治疗组的总有效率为97.14%,对照组的总有效率为82.86%,治疗组总有效率显著高于对照组(P0.05)。治疗后,治疗组2 h、2～24 h出血量、止血时间和恶露持续时间明显低于对照组(P0.05)。治疗后,两组血清D-D、Hb和FIB水平显著降低(P0.05),且治疗组D-D、Hb和FIB水平降低程度较大(P0.05)。治疗后,两组患者血清NOS和NO水平显著降低(P0.05),且治疗组血清NOS和NO水平降低程度较大P0.05)。结论氨甲环酸注射液联合垂体后叶注射液治疗难治性产后出血可以改善临床症状,降低血清NOS、NO、D-D、Hb和FIB水平。

Clinical study on tranexamic acid combined with posterior pituitary in treatment of refractory postpartum hemorrhage

Objective To observe the clinical effect of Yiqi Fumai Lyophilized Injection combined with nicorandil in the treatment of microvascular angina with Qi and Yin deficiency. Methods A total of 80 patients with microvascular angina with Qi and Yin deficiency were randomly selected and divided into the control group (n=40) and the observation group (n=40). The patients in control group were treated with western medicine starardied treatment + po nicorandil 5 mg, 3 times per day, and the patients in observation group were treated as control group + Yiqi Fumai Lyophilized Injection 5.2 g + 0.9% sodium chloride injection 250 mL, intravenous drip, once per day, and two groups were treated 14 days. Clinical efficacy, Duke exercise palte score, Traditional Chinese Medicine (TCM) symptom scores and efficacy were compared between the two groups before and after treatment in two groups were compared. Results After treatment, the total effective rate of treatment of the observation group was 87.50%, the total effective rate of control group was 65.00%, and the effect of the observation group was obviously better than that of the control group, and the difference was statistically. Duke exercise plate score showed that the score and risk stratification in the observation group were better than those in the control group (P<0.05). And the total effective rate of TCM symptom scores and efficacy were compared between the two groups before and after treatment, and there was statistical difference between the two groups (P<0.05). Conclusion It is more effective to add Yiqi Fumai Lyophilized Injection on the basis of conventional western medicine than western medicine alone for patients with microvascular angina pectoris.