目的 探讨联合使用氨甲环酸和卡贝缩宫素对剖宫产术后止血效果及对产妇凝血功能的影响.方法 选自在我院产科2015年1月至2015年6月收治进行剖宫产手术的产妇80例,随机分成联合组和对照组,每组40例,联合组在胎儿安全分娩出后迅速给予静脉滴注氨甲环酸0.5g及卡贝缩宫素100 ug,对照组在产妇分娩出婴儿后给予静脉滴注缩宫素10 U.观察两组产妇在术中、术后2h及术后24 h的出血量及对凝血酶原时间(PT)、活化部分与凝血活酶时间(aPTT)、D二聚体(D-D)和纤维蛋白原(Fbg)水平的影响,并比较术后产妇出现排尿的时间及药物引起不良反应的差异.结果 联合组术后术后出血的比例显著低于对照组,术中、术后2h及术后24 h的出血量均显著低于对照组;联合组的血清PT、aPTT及D-D含量显著低于对照组,血清Fbg含量显著高于对照组;术后联合组出现尿量的时间显著小于对照组;两组产妇的不良反应均未见明显差异.结论 联合使用氨甲环酸和卡贝缩宫素可以有效控制剖宫产术后的出血症状,改善产妇凝血功能,缩短出现排尿的时间,有利于产妇术后的恢复.%Objective To study the combination of tranexamic acid and Carbetocin on the hemostatic effect of cesarean section and maternal blood coagulation function.Methods To choose 80 cases of puerpera wich was done cesarean section surgery in January 2015-June 2015,randomly divided them into the joint group and the control group,40 cases in each group.After the fetus safe delivery out,joint group was given rapidly intravenous infusion 0.5 g of tranexamic acid and 100 ug of Carbetocin,the control group was only given 10 Uoxytocin,and to observe the difference of postoperative bleeding in 0 h,2 h and 24 h,and the prothrombin time (PT),activated partial thromboplastin time (aPTT),D-dimer (D-D) and fibrinogen (Fbg) levels,and compare maternal postoperative voiding time difference and drug-induced adverse reactions.Results The proportion of 0 h,2 h and 24 h in the Joint group postoperative bleeding was significantly lower than the control group;significantly lower serum PT,aPTT and D-D in joint group in the control group,and the serum Fbg in joint group were significantly higher than control group;the joint group appeared time of urine was significantly smaller than the control group.Conclusion Combined use of tranexamic acid and Carbetocin could effectively control bleeding after cesarean section,improving maternal coagulation,shorten time urination,conducive to the resumption of maternal surgery.
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