缩宫素不同应用方法预防剖宫产术后出血的临床随机对照研究

目的 对比分析缩宫素不同应用方法预防剖宫产术后出血的临床效果。方法 100例初产妇均在腰硬联合麻醉下行横切口子宫下段剖宫产术,按照数字随机表法分为试验组和对照组两组。试验组缩宫素10 IU于断脐后宫体注射,另10 IU溶于0.9%氯化钠溶液500 mL静脉滴注;对照组20 IU溶于0.9%氯化钠溶液500 mL静脉滴注。观察产妇术中出血量、产后2 h及产后 24 h出血量、总出血量、其他宫缩剂的应用、血压、心率的变化、手术时间等指标。结果 试验组的术中出血量及总出血量较对照组有减少的趋势,差异具有统计学意义(P＜0.05);两组血红蛋白及红细胞压积下降值差异具有统计学意义(P＜0.05);其他观察指标无统计学意义(P＞0.05)。结论 剖宫产术中缩宫素宫体注射联合静滴缩宫素可以有效的减少术中出血及总失血量,对产妇无风险增加,在单胎妊娠初产妇剖宫产手术中可以有效的替代断脐后单纯静脉滴注缩宫素。

A clinical randomized controlled study of different timing of oxytocin in preventing hemorrhage after cesarean section

Objective To comparatively analyze the clinical effects of different clinical application of oxytocin to prevent hemorrhage after cesarean section (CS).Methods Totally 100 primiparas received transverse CS in the lower segment of the uterus under combined spinal and epidural anesthesia, and were divided into the experiment group and the control group according to random number table method.The experiment group were injected 10 IU oxytocin into the uterine body after the umbilical cord amputation and another 10 IU oxytocin were dissolved in 500mL 0.9% NS for intravenous infusion. While in the control group,20 IU oxytocin were dissolved in 500mL 0.9%NS for intravenous infusion. Indicators were observed including the amount of blood loss during CS,postoperative blood loss 2 hours and 24 hours after CS,the overall blood loss, the use of additional uterotonics, the changes of blood pressure and heart rate, and operation time.Results In the experimental group, the amount of bleeding during CS and the total bleeding decreased in comparison with the control group, and the difference was statistically significant (P＜0.05).The difference of the decrease of hemoglobin and hematocrit in the two groups was statistically significant (P＜0.05).There were no statistical significant differences between both groups about other observational indicators (P＞0.05) .Conclusion Oxytocin intrauterine injection combined with intravenous drip during elective CS can achieve a good hemostatic effect. It can effectively reduce the total loss of blood in the operation and post operation, and there are no additional risks for parturients, so it can effectively replace the intravenous drip of oxytocin after the umbilical cord clipping in the single pregnancy cesarean section.