目的 探讨宫血宁胶囊联合卡前列素氨丁三醇注射液预防产后出血的临床疗效。方法 选择了2017年9月-2019年2月延安大学附属医院妇产科收治的92例产后出血产妇研究对象，将所有产妇随机分为对照组和治疗组，每组各46例。对照组胎儿娩出后立即给予卡前列素氨丁三醇注射液250 μg，对于阴道分娩的产妇进行臀部肌注，对于剖宫产的产妇在术中宫体肌注，给药后实时观察子宫的收缩情况再次给予卡前列素氨丁三醇注射液，总使用剂量应<2 mg。治疗组在对照组治疗的基础上口服宫血宁胶囊，2粒/次，3次/d。两组患者均连续给予3 d。观察两组的临床疗效，比较两组的产后出血情况、凝血指标。结果 治疗后，对照组和治疗组的总有效率分别为71.7%、84.8%，两组比较差异有统计学意义（P<0.05）。治疗后，治疗组产妇产后2、12、24 h的出血量均显著少于对照组，产后止血时间显著短于对照组，两组比较差异有统计学意义（P<0.05）。治疗后，两组产妇的凝血酶原时间（PT）、血浆凝血酶时间（TT）较治疗前均显著升高，纤维蛋白原（FIB）、D-二聚体（D-D）均显著降低，同组治疗前后比较差异有统计学意义（P<0.05）；但治疗组凝血指标水平与对照组相比均无显著差异。结论 宫血宁胶囊联合卡前列素氨丁三醇注射液预防产后出血的临床效果显著，可减少产后出血量和止血时间，调节凝血指标，安全性较好，具有一定临床推广应用价值。

Objective To investigate the clinical effect of Gongxuening Capsules combined with Carboprost Tromethamine Injection in prevention of postpartum hemorrhage. Methods Patients (92 cases) with postpartum hemorrhage in Yan'an University Affiliated Hospital from September 2017 to February 2019 were randomly divided into control and treatment groups, and each group had 46 cases. Patients in the control group were given Carboprost Tromethamine Injection 250 μg, for vaginal delivery, gluteal intramuscular injection, and for cesarean section, intraoperative intrauterine intramuscular injection, after giving the drug, the uterine contraction was observed in real time. The total dose should be less than 2 mg. Patients in the treatment group were po administered with Gongxuening Capsules on the basis of the control group, 2 grains/time, three times daily. Patients in two groups were treated for 3 d. After treatment, the clinical efficacies were evaluated, and postpartum hemorrhage, and coagulation indexes in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 71.7% and 84.8%, respectively, and there was difference between two groups (P<0.05). After treatment, the bleeding volume at 2, 12, and 24 h after delivery in the treatment group were significantly less than those in the control group, and the postpartum hemostasis time after delivery in the treatment group was significantly shorter than that in the control group, and there was difference between two groups (P<0.05). After treatment, PT and TT in two groups were significantly increased, but FIB and D-D in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And there was no significant difference in coagulation indexes between the treatment group and the control group. Conclusion Gongxuening Capsules combined with Carboprost Tromethamine Injection has clinical curative effect in prevention of postpartum hemorrhage, can reduce the amount of postpartum hemorrhage and hemostasis time, and regulate the coagulation indexes, with good safety, which has a certain clinical application value.