联合应用米索前列醇和缩宫素预防剖宫产后出血的临床观察

目的观察联合应用米索前列醇和缩宫素预防剖宫产后出血的临床效果。方法选择2006年1月份起在本院行剖宫产的326例产妇，进行随机分组。试验组175例在打开腹膜后立即舌下含化米索前列醇200μg，胎儿取出后宫体注射缩宫素20U，静脉给予5％GS500mL加缩宫素30U；对照组151例在胎儿取出后立即宫体注射缩宫素20U，静脉再给予5％GS500mL加缩宫素30U。观察两组在产后2h及24h内的出血量。结果试验组产后2h、24h平均出血量分别为（220．65±44．93）mL和（363．65±52．07）mL；而对照组则为（271．47±50．38）mL和（414．53±51．74）mL。两组相比差异有统计学意义（p〈0．05）。结论联合应用米索前列醇和缩宫素预防剖宫产后出血的作用明显强于单独使用缩宫素，且米索前列醇使用方便、安全，特别适合在基层医院使用。

Combination of Misoprostol and Oxytocin for Prevention of Hemorrhage after Cesarean Section

Objective To observe the clinical effects of the combination of misoprostol and oxytocin in the prevention of hemorrhage after cesarean section. Methods We divided 326 cases of cesarean section in our hospital randomly into experimental group（175 cases）and control group（ 151 cases）. The experimental group received the sublingual administration of Misoprostol 200μg immediately after the open peritoneal,then the injection of Oxytocin 20U in uterus and the intravenous injection of 5%GS 500mL＋Misoprostol 30U immediately after fetus was removed. The control group was injected with Oxytocin 20U in uterus with the intravenous injection of 5%GS 500mL ＋ Misoprostol 30U immediately after fetus was removed. The volume of bleeding in both groups at 2h and 24h after cesarean section were measured. Results The volume of bleeding was（220.65 ± 44.93）mL at 2h and （363.65± 52.07）mL at 2dh after cesarean section in the experimental group,while （271.47±50.38）mL at 2h and（414,53±51.74）mL at 24h after cesaean section in the control group,respectively. There was a significant difference between the two groups （P〈0.05）. Conclusion The combination of misoprostol and oxytocin in the prevention of bleeding after cesarean section is more effective than the single use of Oxytoein and it is easy to use misoprostol,safe and particularly suitable for primary hospitals.