目的 探讨注射用矛头蝮蛇血凝酶联合氨甲苯酸治疗剖宫产术后出血的临床疗效。方法 选取2020年7月—2023年6月首都医科大学附属北京妇产医院收治的126例剖宫产产后出血患者，按随机数字表法将患者分为对照组和治疗组，每组各63例。对照组静脉滴注氨甲苯酸氯化钠注射液，0.2 g/次，2次/d。在对照组基础上，治疗组静脉注射注射用矛头蝮蛇血凝酶，每次将1单位溶于10 mL生理盐水，2次/d。两组患者均治疗1 d。观察两组患者临床疗效，比较治疗前后两组患者出血情况，简式抑郁–焦虑–压力量表（DASS-21）评分，及全血血红蛋白（Hb）、血小板计数（PLT）和血小板压积（PCT）水平。结果 治疗后，治疗组总有效率（98.41%）显著高于对照组（87.30%，P＜0.05）。治疗后，治疗组患者0.5、2、24 h的出血量较对照组明显降低（P＜0.05）。治疗后，两组患者DASS-21中各子量表评分及量表总分较治疗前明显下降（P＜0.05），且治疗后治疗组显著低于对照组（P＜0.05）。治疗后，两组全血Hb、PLT、PCT水平均显著上升（P＜0.05），且以治疗组患者升高更明显（P＜0.05）。结论 注射用矛头蝮蛇血凝酶联合氨甲苯酸治疗剖宫产术后出血疗效确切，能在较好的安全性基础上，进一步增强止血效果，有效减少出血量，纠正凝血异常，促进产妇身心恢复。

Objective To investigate the clinical efficacy of hemocoagulase bothrops atrox combined with aminomethylbenzoic acid in treatment of postpartum bleeding after cesarean section. Methods A total of 126 patients with postpartum hemorrhage during cesarean section admitted to Beijing Obstetrics and Gynecology Hospital Affiliated to Capital Medical University from July 2020 to June 2023 were selected and divided into control group and treatment group according to random number table method, with 63 cases in each group. Patients in the control group were iv administered with Aminomethylbenzoic Acid and Sodium Chloride Injection, 0.2 g/time, twice daily. Patients in the treatment group were iv administered with Hemocoagulase Bothrops Atrox for injection on the basis of the control group, 1 unit each time was dissolved in 10 mL normal saline, twice daily. Patients in two groups were treated for 1 d. After treatment, the clinical evaluations were evaluated, and the bleeding, DASS-21 scores, and the levels of whole blood Hb, PLT, and PCT in two groups before and after treatment were compared. Results After treatment, the total effective rate in the treatment group (98.41%) was significantly higher than that in the control group (87.30%, P < 0.05). After treatment, the amount of bleeding at 0.5, 2, and 24 h in the treatment group was significantly lower than that in the control group (P < 0.05). After treatment, the scores of each subscale and the total score of the scale in DASS-21 in two groups were significantly decreased compared with those before treatment (P < 0.05), and the treatment group was significantly lower than that in the control group (P < 0.05). After treatment, the whole blood Hb, PLT, and PCT levels were significantly increased in two groups (P < 0.05), and the increase was more significant in the treatment group (P < 0.05). Conclusion Hemocoagulase Bothrops Atrox for injection combined with aminomethylbenzoic acid has a definite effect on post-cesarean section bleeding. It can further enhance the hemostatic effect on the basis of good safety, effectively reduce the amount of bleeding, correct coagulation abnormalities, and promote maternal physical and mental recovery.

R984

北京市医院管理中心“青苗”计划专项经费资助（QML20181401）