目的 研究氨甲環(huán)酸注射液聯(lián)合垂體后葉注射液治療難治性產(chǎn)后出血的臨床療效。方法 選取2016年12月-2019年12月在洛陽(yáng)東方醫(yī)院治療的70例難治性產(chǎn)后出血患者，將所有患者隨機(jī)分為對(duì)照組和治療組，每組各35例。對(duì)照組患者靜脈滴注垂體后葉注射液，6 U溶于5%葡萄糖注射液500 mL中，控制滴速為0.02~0.04 U/min。治療組患者在對(duì)照組基礎(chǔ)上緩慢靜脈滴注氨甲環(huán)酸注射液，1 g溶于5%葡萄糖注射液500 mL中。觀察兩組臨床療效，比較兩組的出血量、止血時(shí)間和惡露持續(xù)時(shí)間、血液學(xué)指標(biāo)D-二聚體（D-D）、血紅蛋白（Hb）、血漿纖維蛋白原（FIB）和血清因子一氧化氮合酶（NOS）和一氧化氮（NO）、水平。結(jié)果 治療后，治療組的總有效率為97.14%，對(duì)照組的總有效率為82.86%，治療組總有效率顯著高于對(duì)照組（P<0.05）。治療后，治療組2 h、2~24 h出血量、止血時(shí)間和惡露持續(xù)時(shí)間明顯低于對(duì)照組（P<0.05）。治療后，兩組血清D-D、Hb和FIB水平顯著降低（P<0.05），且治療組D-D、Hb和FIB水平降低程度較大（P<0.05）。治療后，兩組患者血清NOS和NO水平顯著降低（P<0.05），且治療組血清NOS和NO水平降低程度較大P<0.05）。結(jié)論 氨甲環(huán)酸注射液聯(lián)合垂體后葉注射液治療難治性產(chǎn)后出血可以改善臨床癥狀，降低血清NOS、NO、D-D、Hb和FIB水平。

Objective To study the efficacy of Tranexamic Acid Injection combined with Posterior Pituitary Injection in treatment of refractory postpartum hemorrhage. Methods Patients (70 cases) with refractory postpartum hemorrhage in Luoyang Dongfang Hospital from December 2016 to December 2019 were randomly divided into control and treatment groups, and each group had 35 cases. Patients in the control group were iv administered with Posterior Pituitary Injection, 6 U added into 5% glucose solution 500 mL, and the dropping rate was controlled at 0.02-0.04 U/min. Patients in the treatment group were iv administered with Tranexamic Acid Injection on the basis of the control group, 1 g added into 5% glucose solution 500 mL. After treatment, the clinical efficacies were evaluated, and the bleeding volume, the hemostasis time, the lochia duration, the levels of hematological indicator D-D, Hb, FIB, and serum factors NOS and NO in two groups were compared. Results After treatment, the total effective rate of the treatment group was 97.14%, and that of the control group was 82.86%, and the total effective rate of the treatment group was significantly higher than that of the control group (P < 0.05). After treatment, the bleeding volume, hemostasis time, and lochia duration in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the serum levels of D-D, Hb, and FIB in two groups were significantly decreased (P < 0.05), and the serum levels of D-D, Hb, and FIB in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the serum levels of NOS and NO in two groups were significantly decreased (P < 0.05), and the serum levels of NOS and NO in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Tranexamic Acid Injection combined with Posterior Pituitary Injection in treatment of refractory postpartum hemorrhage can improve the clinical symptoms, reduce the serum levels of NOS, NO, D-D, Hb, and FIB.

R984

河南省醫(yī)學(xué)科技攻關(guān)計(jì)劃項(xiàng)目（201702091）