目的 探討新生化片聯(lián)合馬來酸麥角新堿注射液治療宮縮乏力性產(chǎn)后出血的臨床療效。方法 選擇2021年10月—2022年6月在首都醫(yī)科大學(xué)附屬北京婦產(chǎn)醫(yī)院懷柔婦幼保健院治療的246例宮縮乏力性產(chǎn)后出血患者，根據(jù)用藥的差別分為對(duì)照組和治療組，每組各123例。對(duì)照組靜脈注射馬來酸麥角新堿注射液，0.2 mg/次加入生理鹽水10 mL，持續(xù)時(shí)間最少1 min，必要時(shí)可2～4 h重復(fù)注射1次，最多5次；在對(duì)照組基礎(chǔ)上，治療組口服新生化片，4片/次，3次/d。兩組患者均經(jīng)5 d治療。觀察兩組患者臨床療效，比較治療前后兩組患者出血量，止血時(shí)間，癥狀改善時(shí)間，CES-D評(píng)分、STAI評(píng)分和GSES評(píng)分，及血清抗凝血酶-Ⅲ（AT-III）、血管內(nèi)皮生長(zhǎng)因子（VEGF）、腦尿利肽（BNP）、去甲腎上腺素（NE）、腎上腺素（E）和一氧化氮（NO）水平。結(jié)果 經(jīng)治療，治療組的臨床總有效率為98.37%，明顯高于對(duì)照組（88.62%，P＜0.05）。經(jīng)治療，治療組在治療2、12、24 h的出血量和止血時(shí)間均優(yōu)于對(duì)照組（P＜0.05）。經(jīng)治療，治療組癥狀改善時(shí)間均早于對(duì)照組（P＜0.05）。經(jīng)治療，兩組GSES評(píng)分比治療前明顯升高，而STAI評(píng)分和CES-D評(píng)分比治療前明顯降低（P＜0.05），且治療組評(píng)分明顯好于對(duì)照組（P＜0.05）。經(jīng)治療，兩組AT-Ⅲ、BNP、NO、NE、E水平比治療前明顯降低，而VEGF水平比治療前明顯升高（P＜0.05），且治療組這些血清細(xì)胞因子水平明顯好于對(duì)照組（P＜0.05）。結(jié)論 新生化片聯(lián)合馬來酸麥角新堿注射液治療宮縮乏力性產(chǎn)后出血效果良好，可促提高患者自我效能感，減輕患者焦慮抑郁癥狀。

Objective To investigate the clinical effect of Xinshenghua Tablets combined with ergometrine maleate in treatment of postpartum hemorrhage due to uterine atony. Methods Patients (246 cases) with postpartum hemorrhage due to uterine atony in Huairou Maternity and Child Health Hospital of Beijing Maternity and Obstetrics Hospital of Capital Medical University from October 2021 to June 2022 were divided into control and treatment group bases on different treatments, and each group had 123 cases. Patients in the control group was iv administered with Ergometrine Maleate Injection, 0.2 mg added into normal saline 10 mL, the duration of the injection was at least 1 min, and another injection can be repeated once in 2 to 4 h if necessary, up to 5 times. Patients in the treatment group were po administered with Xinshenghua Tablets on the basis of the control group, 4 tablets/time, three times daily. Patients in two groups were treated for 5 d. After treatment, the clinical evaluation was evaluated, and the bleeding volume and the time of hemostatic, the improvement time of symptom, the scores of CES-D, STAI, and GSES, the levels of serum AT-Ⅲ, BNP, NO, NE, E, and VEGF in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 98.37%, which was significantly higher than that of the control group (88.62%, P < 0.05). After treatment, the bleeding volume and hemostatic time in the treatment group were better than those in the control group at 2, 12 and 24 h (P < 0.05). After treatment, the time of symptom improvement in the treatment group was earlier than that in the control group (P < 0.05). After treatment, the GSES score in two groups was significantly higher than that before treatment, while the STAI score and CES-D score in two groups were significantly lower than those before treatment (P < 0.05), and the scores in the treatment group were significantly better than that of the control group (P < 0.05). After treatment, the levels of AT-Ⅲ, BNP, NO, NE, and E in two groups were significantly lower than those before treatment, while the level of VEGF was significantly higher than that before treatment (P < 0.05), and the levels of serum cytokines in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion The effect of Xinshenghua Tablets combined with ergometrine maleate in treatment of postpartum hemorrhage due to uterine atony is good, which can improve the patients' sense of self-efficacy and reduce the symptoms of anxiety and depression.

R984

北京市懷柔區(qū)衛(wèi)生和計(jì)劃生育委員會(huì)科研項(xiàng)目（2018-A-003）