【摘要】 目的 探讨不同剂量的马来酸麦角新碱联合缩宫素对剖宫产术后一氧化氮（NO）、一氧化氮合酶（NOS）及D-二聚体（D-D）水平的影响。方法 选取2020年1月至2020年12月于廊坊市人民医院产科接受剖宫产的186例孕妇作为研究对象，采用随机数字表法将其分为对照组、观察1组与观察2组各62例。对照组仅予以宫体内10U缩宫素，观察1组在对照组的基础上剖宫产术后予以马来酸麦角新碱0.2 mg宫体注射，观察2组在对照组的基础上剖宫产术后予以马来酸麦角新碱0.4 mg宫体注射。比较3组术中、术后2 h、术后24 h的出血量，比较3组术前、术后12 h的NO、NOS及D-D水平，同时观察三组治疗期间不良反应。结果 术后2 h与术后24 h患者出血量：对照组>观察1组>观察2组，差异具有统计学意义（F=14.064、33.633,P<0.05）。三组术后12 h的NO、NOS水平均低于术前、对照组与观察1组术后12 h D-D水平低于术前，差异有统计学意义(t_NO=5.067、11.592、13.657,t_NOS=9.082、15.817、17.036,t_D-D=7.245、4.134,P<0.05)；术后12 h患者NO、NOS水平：对照组>观察1组>观察2组，D-D水平：观察2组>观察1组>对照组，差异具有统计学意义(F_NO、NOS=46.263,50.412,F_D-D=32.758,P<0.05)。对照组、观察1组、观察2组治疗期间不良反应发生率分别为11.29%、6.45%、9.68%，三组比较差异无统计学意义（χ²=3.812,P>0.05）。结论 马来酸麦角新碱联合缩宫素可降低剖宫产产后出血量、改善血管内皮与凝血功能，0.4 mg剂量较0.2 mg剂量的马来酸麦角新碱效果更显著，不良反应不明显。更多还原

【Abstract】 Objective To investigate the effect of different doses of ergonovine maleate combined with oxytocin on the levels of nitric oxide（NO）,nitric oxide synthase（NOS）,and D-Dimer（D-D）after cesarean section. Methods A total of 186 pregnant women who underwent cesarean section at the Department of Obstetrics,Langfang People’s Hospital,from January 2020 to December 2020 were selected as study subjects and divided into control,observation 1,and observation 2 groups using the random number table method with 62 cases each. Control group received only 10 U of oxytocin by EC,group 1 was treated with 0.2 mg of intrauterine injection of edonerpic maleate after cesarean section based on the control group,and group 2 was treated with 0.4 mg of intrauterine injection of edonerpic maleate after cesarean section on the basis of the control group. The blood loss of the three groups at the time of operation,2 h and 24 h after operation,and the levels of NO,NOS and D-D among the three groups before operation,12 h after operation,the adverse effects during the treatment among the three groups were compared. Results The difference was statistically significant between the 2 h postoperative and 24 h postoperative blood loss control groups > observation 1 > observation 2 groups（F=14.064,33.633,P<0.05）. The levels of NO and NOS at 12 h after surgery among three groups were lower than those before surgery,and the levels of D-D at 12 h after surgery in the control and observation 1 group were lower than those before surgery(t_NO=5.067,11.592,13.657,and t_NOS=9.082,15.817,17.036,and t_D-D=7.245,4.134,respectively,P<0.05). The levels of NO and NOS in patients 12 h after operation were controlled > observation 1 > observation 2,D-D level:observation 2 > observation 1 > control,and the differences were specifically statistically significant(F_NO,NOS= 46.263,50.412,F_D-D= 32.758,P<0.05). The incidence of adverse reactions during treatment in the control,observation 1,and observation 2 groups were11.29%,6.45%,and 9.68%,respectively,with no significant differences among the three groups（χ²=3.812,P>0.05）. Conclusion The combination of ergometrine maleate and oxytocin can reduce postpartum hemorrhage,improve vascular endothelial and coagulation function after cesarean section. The 0.4mg dose of ergometrine maleate has a more significant effect than the 0.2 mg dose,and the adverse reactions are not significant.更多还原