米索前列醇联合催产素预防剖宫产术后出血疗效观察

【目的】探讨米索前列醇联合催产素用于预防剖宫产术后出血的临床疗效。【方法】选择112例择期行剖宫产的孕妇随机分为缩宫素组（O组）和米索前列醇与催产素联合组（OM组）,每组56例,O组胎儿娩出后立即静脉注射催产素10U,同时静脉滴注催产素10U;O-M组给催产素的同时在手术切开子宫前将米索前列醇200μg塞入直肠,观察记录两组孕妇的术中出血量、产后2h出血量、产后24h出血量及总出血量,检测术前及术后24h的血红蛋白含量,记录平均动脉压（MAP）、心率（HR）的变化及不良反应发生情况。【结果】术中出血量两组无统计学差异（P〉0．05）;OM组产后2h出血量、产后24h出血量及总出血量均少于O组（P〈0．05）;O组发生产后出血4例,发生率高于OIM组（P〈0．05）;OM组术后24h的血红蛋白含量高于O组（P〈0．05）;两组MAP、HR的变化及不良反应发生情况比较无统计学差异（P〉0．05）。【结论】米索前列醇联合催产素用于预防剖宫产术后出血具有应用简单、效果较好、易于掌握、副作用小等特点,值得推广应用。

Clinical Observation of Misoprostol Combined with Oxytocin for Preventing Postpartum Hemorrhage of Scarred Uterus During Cesarean Section Delivery

[Objective] To observe the clinical effect of misoprostol combined with oxytocin for preventing postpartum hemorrhage of scarred uterus during cesarean section delivery. [Methods] A total of 112 multigestas with elective caesarean section were randomly divided into 2 groups with 56 cases for each group. Group O was injected 10U oxytocin just after delivery and 10U of oxytocin iv gtt. Group O-M was added 200μg misoprostol per rectum. Bleeding volume during surgery, 2h after surgery and 24h after surgery and the total volume were recorded. Hemoglobin（Hb） before and 24h after surgery was measured, and the changes of MAP, HR and adverse effects were recorded. [ResultslThere was no significant difference in bleeding volume during surgery between two groups（ P 〉0.05）. The bleeding volume at 2h and 24h after surgery and total volume in group O-M were less than those in group O（ P 〉0.05）. Postpartum hemorrhage occurred in 4 cases of group O, which was higher than that in group O-M（ P %0.05）. Hb at 24h after surgery in group O-M was higher than that in group O（ P 〈0.05）. There was no significant difference in MAP, HR and adverse effects between two groups（ P 〈 0.05）. [Conclusion]Misoprostol combined with oxytocin for preventing postpartum hemorrhage of scarred uterus during cesarean section delivery is simple and effective, and is apt to grasp, and has less adverse effects, so it is worthy of being extended.