Study of drug control over postoperative hemorrhage after selective caesarean section

Objective: To compare the efficacy and safety of carbetocin and oxytocin in the prevention of postpartum hemorrhage after selective caesarean section. Methods: Two hundred and sixteen pregnant women who were going to deliver by caesarean section were randomly divided into two paralleled and controlled groups, of which the oxytocin group(group A) contained 105 women and the carbetocin group(group B) 111 women. 20 IU of oxytocin was administrated during operation for both groups, 10 IU directly into uterus and 10 IU intravenously. When the operation was over, 20 IU of oxytocin was dripped for group A lasting for 8 hours, while for group B 100μg of carbetocin was immediately injected intravenously for 1 minute. Blood loss as well as hemoglobin alteration was measured for the comparison of the effect of the two drugs. Blood biochemical indicators were introduced for the evaluation of the safety of carbetocin including the function of liver and kidney and the fasting glucose.Results: No significant difference was revealed between the two groups concerning the postpartum hemorrhage within 24 hours, the postpartum hemorrhage incidence and the changes of hemoglobin. There was no significant difference in the change of liver and kidney function, fasting glucose and electrolyte changes as well.Conclusions: Carbetocin has a similar effect and safety of oxytocin in controlling the blood loss of selective caesarean section.     

98例双胎母婴危险因素分析

随着围产医学的发展,双胎妊娠给母婴带来诸多临床问题,现将我院１９９４年１２月～１９９９年１２月五年间出生的９８例双胎临床分析如下：１临床资料１．１一般资料：本组９８例双胎均为我院产科住院者。其中农民４８人,工人１７人,干部７人,无业及其他职业２６人。第一胎４３例,第二胎５６人。１． ２妊娠合并症：妊高症 ４２例（ ４５． ７％）,顺位（ １）;羊水过多 ３０例（ ３２． ６％）,顺位（ ２）;贫血 １０例（１０．８６％）,顺位（３）;产前子痫５例（５．４３％）,顺位（４）;心肌炎 ２例（ ２． １７％）,顺…     

剖宫产率升高及指征的变化分析

目的分析剖宫产率升高及指征变化的原因,并制定出相应的对策。方法采用回顾性分析的方法,对我院2000年1月至2004年12月住院分娩产妇的剖宫产病例进行分析。结果剖宫产率逐年升高,剖宫产指征中社会因素所占比例明显增高。结论社会因素是剖宫产率升高的主要原因,降低剖宫产率关键是减少社会因素,加强宣传剖宫产术的适应症及并发症,开展无痛分娩。     

中药治疗ABO母婴血型不合溶血病至高胆红素血症临床疗效观察

目的 探讨早期简便有效治疗ABO母婴血型不合性高胆红素血症(ABO HDN With HUCB)的新方法,方法自1997年6月～2006年1月期间在本院分娩并因黄疸确诊为ABO HDN With HUCB 病例,随机选取92例,生后24小时内发现黄疸单纯口服中药茵桅黄口服液为A组(n=46).≥24～72小时发现黄疸为B组(n=46),A组,B组口服同样药物并按常规方法光疗,静脉输白蛋白,同时两组均在最初发现黄疸时取股静脉血,之后用经皮测黄疸仪监测胆红素峰值A组于＞72小时降至＜12.9mgldl.B组降至＜9mgldl为治愈.结果 2组相比有3种显著差异1、总胆红素峰值A组104.68±17.3umoi/l,B组16.27±52.28umoi/l,p＜0.001.2、喂养方式,A组全部母乳喂养,并在母婴同室,B组全部在NZCU由护士用配方奶喂养.3、平均住院天数,A组5.33±0.62天,B组10.39±2.92天,p＜0.001.结论 中药茵桅黄口服液对治疗在分娩后24小时内发现的ABO HDN With HUCB的疗效是可信的.     

宫角妊娠治疗方法的探讨

目的 总结分析宫角妊娠的不同治疗方法，提出最佳治疗方案。方法 分析1998年1月1日至2004年12月31日收治的60例宫角妊娠病人的临床资料、超声及病理结果。将治疗方法归纳为5组：第1组B超直视下刮宫；第2组B超直视下刮宫联合宫颈注射MTX；第3组B超直视下刮宫失败，剖腹行患侧宫角切除手术；第4组B超直视下刮宫失败，腹腔镜下行患侧宫角切除或刮宫联合宫角部注射MTX手术；第5组口服杀胚胎中药保守治疗。结果 第1组23例；第2组9例；第3组18例；第4组8例；第5组2例。从1998-2004年宫角妊娠的例数呈逐年增加的趋势。腹腔镜已成功用于宫角妊娠的手术治疗；B超下刮宫及联合MTX治愈的比例有呈逐年增加的趋势。发生在右侧的例数明显多于左侧的例数。结论 宫角妊娠根据病情的不同可以采取多种治疗方法。应根据患者的不同病情采取损伤最小、恢复最快、预后最好的治疗方案。发生腹腔内出血的病例以行开腹手术为宜。血HCG值明显低于相应孕周的病例可住院口服杀胚胎中药。B超下刮宫在保留了患者解剖结构的完整性的同时避免了手术后的粘连。B超下刮宫联合MTX宫颈注射，提高了保守治疗的成功率，但治疗时间长，宜用腹腔镜手术代替。超声直视下刮宫失败或合并具有剖腹指征的病例行腹腔镜治疗是最佳选择。     

The Safety of Electroacupuncture at Hegu （LI 4） plus Oxytocin for Hastening Uterine Contraction of Puerperants --A Randomized Controlled Clinical Observation

To investigate the safety of electroacupuncture plus oxytocin for uterine contraction of puerperants. Methods： 276 puerperants with difficult labor were randomly divided into a medication group, treated with intravenous dripping of oxytocin, and an acupuncture plus medication group, in the medication group, intravenous dripping of oxytocin was given, and in the other group, acupuncture at bilateral Hegu （LI 4） was added. Heart rate, respiratory frequency, blood pressure of puerperants, fetal heart rate and birth process were observed. Results： During laboring, the indices observed, including heart rate, respiratory frequency, blood pressure, fetal heart rate and birth process, were all in normal range in all of the 276 cases, with better effects in acupuncture plus medication Group M. Conclusions： Electroacupuncture at bilateral Hegu （LI 4） plus intravenous dripping of oxytocin can intensify the uterine contraction, shorten the birth process to avoid probable systemic exhaustion due to excessive consumption, and with no side effects on life signs of the puernerants and newborns.     

针刺膻中穴治疗产后缺乳的临床疗效研究

目的研究针刺膻中穴治疗产后缺乳的临床作用,为确定腧穴主治提供临床依据。方法采用多中心单盲随机对照研究方法,将276例乳汁不足的产妇随机分为针刺组与中药组,连续治疗3天,观察乳房充盈程度、泌乳量、泌乳素及新生儿体重、人工喂养次数和容量、婴儿小便次数、哭闹时间长短等指标,对照比较治疗产后缺乳的临床疗效。结果针刺组与中药组均能有效改善缺乳状态,乳房充盈程度、泌乳量及新生儿体重、人工喂养次数和容量、婴儿小便次数等治疗前后比较差异均有统计学意义,两组之间比较差异无统计学意义。针刺组治疗前后泌乳素无差异,中药组治疗前后泌乳素有差异。结论针刺膻中穴能有效促进乳汁的分泌。     

电针合谷对子宫收缩乏力产妇宫缩时间的影响

目的:评价合谷穴对子宫收缩乏力的治疗作用与应用价值。方法:3个中心共276例产妇入组,所有病例随机分为针药组和药物组。药物组采用静脉滴注催产素治疗,针药组在药物组治疗基础上加电针合谷。观察电针合谷对子宫收缩乏力的影响,以及对宫缩持续时间和间歇时间的影响。结果:针药组对子宫收缩乏力的总有效率为97·1%,而药物组为70·3%,两组比较,差异有非常显著性意义(P<0·01);与药物组相比,针药组在治疗后0·5、1、1·5、2小时,对宫缩持续时间和间歇时间的影响差异有显著或非常显著性意义(P<0·05,P<0·01)。结论:由于产力异常而导致的难产可采用电针合谷的方法。     

电针刺激合谷穴对分娩的镇痛效果

目的观察电针刺激合谷穴对产妇宫缩的镇痛作用。方法采用多中心研究，对入选病例随机分为针药组和药组。结果针药组和药组在治疗后0．5、1、1．5、2h的产妇疼痛VAS类比评分和医生评分结果，差异显著。针药组疼痛评分低于药组。结论针刺合谷穴用于产妇分娩，不但可以加强宫缩，协调生产环节，还有较好的镇痛效果。     

中药治疗ABO母婴血型不合溶血病至高胆红素血症临床疗效观察

目的探讨早期简便有效治疗ABO母婴血型不合性高胆红素血症(ABOHDNWithHUCB)的新方法,方法自1997年6月～2006年1月期间在本院分娩并因黄疸确诊为ABOHDNWithHUCB病例,随机选取92例,生后24小时内发现黄疸单纯口服中药茵桅黄口服液为A组(n=46)。≥24~72小时发现黄疸为B组(n=46),A组,B组口服同样药物并按常规方法光疗,静脉输白蛋白,同时两组均在最初发现黄疸时取股静脉血,之后用经皮测黄疸仪监测胆红素峰值A组于>72小时降至<12.9mgldl.B组降至<9mgldl为治愈。结果:2组相比有3种显著差异:1、总胆红素峰值A组104.68±17.3umoi/l,B组16.27±52.28umoi/l,p<0.001。2、喂养方式,A组全部母乳喂养,并在母婴同室,B组全部在NZCU由护士用配方奶喂养。3、平均住院天数,A组5.33±0.62天,B组10.39±2.92天,p<0.001。结论:中药茵桅黄口服液对治疗在分娩后24小时内发现的ABOHDNWithHUCB的疗效是可信的。