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目的研究氨甲环酸联合缩宫素降低子宫肌瘤剔除术围术期出血量的临床效果。方法选取2012年6月—2014年1月于苏州市中西医结合医院进行子宫肌瘤剔除术治疗的90例子宫肌瘤患者为研究对象,将其随机分为A组(氨甲环酸组)30例、B组(缩宫素组)30例和C组(氨甲环酸联合缩宫素组)30例。比较3组患者术中及术后出血量所占比例和手术前后的凝血相关指标(CD61、CD62P及D-D)。结果 C组术中出血量<300ml及术后出血量<100ml所占比例均高于A组及B组,差异有统计学意义(P<0.05),但A组与B组的术中出血量<300ml及术后出血量<100ml所占比例比较,差异无统计学意义(P>0.05)。术前3组患者的CD61、CD62P及D-D水平比较,差异无统计学意义(P>0.05),术后12h C组的CD61、CD62P及D-D水平均高于A、B组,A组的CD61、CD62P及D-D水平高于B组,差异有统计学意义(P<0.05)。结论氨甲环酸联合缩宫素在降低子宫肌瘤剔除术围术期出血量中的临床效果明显优于单用氨甲环酸或缩宫素。
Objective To study the clinical effect of tranexamic acid combined with oxytocin in reducing perioperative bleeding during myomectomy. Methods 90 cases of uterine leiomyoma treated by myomectomy in Suzhou Hospital of Integrated Traditional Chinese and Western Medicine from June 2012 to January 2014 were selected and randomly divided into group A (tranexamic acid) 30 cases in group B (oxytocin group) 30 cases and group C (tranexamic acid combined oxytocin group) 30 cases. The proportions of intraoperative and postoperative bleeding and the indexes of coagulation before and after operation (CD61, CD62P and D-D) were compared between the three groups. Results The intraoperative blood loss <300ml and postoperative bleeding <100ml in C group were higher than those in A and B group (P <0.05), but the intraoperative blood loss in A group and B group <300ml and postoperative bleeding <100ml, the difference was not statistically significant (P> 0.05). The levels of CD61, CD62P and DD in group C before operation were significantly higher than those in group A and B at 12h after operation (P> 0.05). There were no significant differences in CD61, CD62P and DD between the three groups before operation (P> 0.05) The levels of CD62P and DD were higher in group B than those in group B (P <0.05). Conclusion The combination of tranexamic acid and oxytocin in the reduction of perioperative bleeding during myomectomy is superior to tranexamic acid or oxytocin alone.