宮血寧膠囊治療人工流產(chǎn)術(shù)后陰道出血

李　婷

(張家口市第六醫(yī)院婦產(chǎn)科，河北 張家口 075000)

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宮血寧膠囊治療人工流產(chǎn)術(shù)后陰道出血

李婷

(張家口市第六醫(yī)院婦產(chǎn)科，河北 張家口 075000)

摘要：目的探討宮血寧膠囊用于人工流產(chǎn)術(shù)后陰道出血的臨床效果。方法選擇行人工流產(chǎn)術(shù)孕婦150例為研究對(duì)象，隨機(jī)分為觀察組和對(duì)照組，各75例。2組均在行人工流產(chǎn)術(shù)前2 d空腹口服米非司酮，上午8∶00 50 mg，晚上20∶00 25 mg，服藥前后禁食2 h，共服用2 d；術(shù)后給予口服奧硝唑膠囊0.5 g/次，2次/d，鹽酸左氧氟沙星0.2 g/次，3次/d。觀察組在此基礎(chǔ)上口服宮血寧膠囊0.26 g/次，3次/d。2組連續(xù)服用7 d，于流產(chǎn)后7、14、30 d復(fù)查。于治療7 d后測定凝血功能4項(xiàng)，觀察2組用藥后陰道出血情況及出血持續(xù)時(shí)間。結(jié)果觀察組PT、TT、APTT水平低于對(duì)照組，F(xiàn)IB水平高于對(duì)照組(P<0.05)；觀察組出血量小于月經(jīng)量占80.0%，等同于月經(jīng)量占17.3%，大于月經(jīng)量占2.7%，與對(duì)照組的48.0%、40.0%、2.7%比較，差異有統(tǒng)計(jì)學(xué)意義(P<0.05)；觀察組陰道出血時(shí)間≤ 7 d占77.3%，8～14 d占20.0%，15～30 d占2.7%，與對(duì)照組的52.0%、33.3%、14.7%比較，差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論流產(chǎn)后服用宮血寧膠囊可有效促進(jìn)流產(chǎn)后子宮復(fù)舊，減少陰道出血天數(shù)及出血量。

關(guān)鍵詞：人工流產(chǎn)術(shù)；宮血寧膠囊；陰道出血

終止早期妊娠的人工流產(chǎn)方法包括手術(shù)流產(chǎn)和藥物流產(chǎn)[1]。但流產(chǎn)后易出現(xiàn)腹痛、陰道出血量多、出血時(shí)間長、月經(jīng)紊亂等現(xiàn)象，嚴(yán)重者還需行二次清宮術(shù)，從而增加患者痛苦[2-3]。本研究對(duì)人工流產(chǎn)術(shù)后孕婦給予宮血寧膠囊口服，觀察陰道出血情況。現(xiàn)報(bào)道如下。

1資料與方法

1.1一般資料選擇2014年8月—2015年8月在我院行人工流產(chǎn)術(shù)的孕婦150例為研究對(duì)象，隨機(jī)分為觀察組和對(duì)照組，各75例，所有受試者平素月經(jīng)周期均規(guī)律，尿HCG(+)，經(jīng)彩色B超確診為宮內(nèi)早期妊娠，并自愿接受終止妊娠，且無人工流產(chǎn)術(shù)禁忌證。2組孕婦年齡、孕周、體質(zhì)量等一般資料比較，差異無統(tǒng)計(jì)學(xué)意義(P>0.05)。

1.2治療方法2組均在行人工流產(chǎn)術(shù)前2 d空腹口服米非司酮，上午8∶00 50 mg，晚上20∶00 25 mg，服藥前后禁食2 h，共服用2 d。術(shù)后給予口服奧硝唑膠囊0.5 g/次，2次/d，鹽酸左氧氟沙星0.2 g/次，3次/d。觀察組在此基礎(chǔ)上口服宮血寧膠囊0.26 g/次，3次/d。2組連續(xù)服用7 d。于流產(chǎn)后7、14、30 d復(fù)查。

2結(jié)果

2.12組凝血功能4項(xiàng)比較見表1。

表1　2組凝血功能4項(xiàng)比較

注：與對(duì)照組比較，#P<0.05

2.22組陰道出血情況比較見表2。

表2　2組陰道出血情況比較(n=75)　例(%)

注：與對(duì)照組比較，#P<0.05

2.32組陰道出血時(shí)間比較見表3。

表3　2組陰道出血時(shí)間比較(n=75)　例(%)

注：與對(duì)照組比較，#P<0.05

3小結(jié)

流產(chǎn)術(shù)后陰道出血原因[4-6]較多，宮血寧膠囊主要成分為重樓皂甙，其藥理作用[7-8]：1)收縮子宮平滑肌，促進(jìn)子宮復(fù)舊和止血；促進(jìn)細(xì)胞鈣離子內(nèi)流，動(dòng)員細(xì)胞內(nèi)鈣使其濃度升高，促進(jìn)前列腺素合成，促進(jìn)及加強(qiáng)子宮平滑肌收縮。2)止血作用：縮短出凝血時(shí)間，誘導(dǎo)血小板聚集，促進(jìn)血小板內(nèi)容物釋放。3)抗炎作用：增加毛細(xì)血管通透性，促進(jìn)血管內(nèi)皮細(xì)胞增殖，增加外周白細(xì)胞和吞噬細(xì)胞數(shù)量，加強(qiáng)末梢血管收縮，炎性物質(zhì)滲出，調(diào)節(jié)系統(tǒng)的功能應(yīng)答。本研究結(jié)果提示，流產(chǎn)后服用宮血寧膠囊可有效促進(jìn)流產(chǎn)后子宮復(fù)舊，減少陰道出血天數(shù)及出血量，且服藥安全方便。

參考文獻(xiàn)：

[1]謝幸,茍文麗.婦產(chǎn)科學(xué)[M].8版.北京:人民衛(wèi)生出版社,2014:383.

[2]辛華,鄭定容,周偉.米非司酮與米索前列醇配伍宮血寧膠囊在終止妊娠中的臨床觀察[J].中國醫(yī)藥導(dǎo)報(bào),2010,7(12):99-100.

[3]賴放穎,張曉燕.縮宮素與米非司酮對(duì)人工流產(chǎn)術(shù)后陰道出血的效果及不良反應(yīng)比較[J].中國當(dāng)代醫(yī)藥,2015,22(1):114-116.

[4]徐怡,盧雨蓮,石寶珠.宮血寧膠囊用于藥物流產(chǎn)后出血孕婦的臨床療效分析[J].抗感染藥學(xué),2015,12(3):423.

[5]朱慧玲,程利南.藥物流產(chǎn)后陰道出血的原因分析和治療現(xiàn)狀[J].中國計(jì)劃生育學(xué)雜志,2006,14(9):569-571.

[6]程慧玲,趙秋萍.分析藥物流產(chǎn)后陰道出血相關(guān)因素及藥物治療療效[J].中外醫(yī)療,2014,14(24):3-4.

[7]龐蓉蓉.逐瘀膠囊治療產(chǎn)后惡露不絕臨床療效觀察[J].亞太傳統(tǒng)醫(yī)藥,2014,10(3):97-98.

[8]王淼,陸智義.產(chǎn)后宮清湯防治藥物流產(chǎn)后陰道出血?dú)馓撗鲂团R床觀察[J].吉林中醫(yī)藥,2012,32(10):1033.

Gongxuening capsule in treatment of vaginal bleeding after artificial abortion

LI Ting

(Department of Gynecology and Obstetrics,The Sixth Hospital of Zhangjiakou City in Hebei Province, Zhangjiakou 075000,Hebei Province,China)

Abstract：ObjectiveTo explore the clinical effect of Gongxuening capsule in the treatment of vaginal bleeding after artificial abortion.MethodsA total of 150 pregnant women were randomized into the observation group and the control group.The pregnant women in the two groups were orally took mifepristone 2 d before artificial abortion,50 mg at 8 am,25 mg at 8 pm,fasting for 2 h before and after taking medicine,for 2 d.After operation,they were orally given ornidazole capsule 0.5 g,twice/d,levoflxacin hydrochloride 0.2g,three times a day.On this basis,the pregnant women in the observation group were orally given Gongxuening capsule 0.26g,three times a day.The pregnant women in the two groups were given a continuous 7 day treatment.The patients were told to recheck 7 d,14 d,1 month after abortion.The coagulation function 7 d after treatment was determined.The vaginal bleeding and bleeding duration after medication in the two groups were observed.ResultsPT,TT,and APTT levels in the observation group were significantly lower than those in the control group,FIB level was significantly higher than that in the control group (P<0.05).After medication,the amount of bleeding in 80.0% was less than,17.3% equal to,and 2.7% greater than the menstrual blood volume in the observation group,while in the observation group were 48.0%,40.0%,2.7%,respectively,and the comparison between the two groups was statistically significant (P<0.05).In the observation group,77.3% patients had vaginal bleeding time ≤7 d,20.0% 8-14 d,2.7% 15-30 d,while in the control group were 52.0%,33.3%,14.7%,respectively,and the comparison between the two groups was statistically significant (P<0.05).ConclusionTaking Gongxuening capsule after abortion can effectively promote the uterine involution,reduce the vaginal bleeding days and amount with a safety and convenience;therefore,it deserves to be widely recommended in the clinic.

Keywords：artificial abortion;Gongxuening capsule;vaginal bleeding

收稿日期:(本欄責(zé)任編輯：張海洋2015-11-02)

文章編號(hào)：2095-6258(2016)02-0367-02

中圖分類號(hào)：R271.9

文獻(xiàn)標(biāo)志碼：A

作者簡介：李婷(1973-)，女，大學(xué)本科，副主任醫(yī)師，主要從事婦產(chǎn)科疾病研究。

基金項(xiàng)目：張家口市科學(xué)技術(shù)研究與發(fā)展指導(dǎo)計(jì)劃項(xiàng)目(1021057D)。

DOI:10.13463/j.cnki.cczyy.2016.02.053