米索前列醇预防剖宫产术后出血的临床研究

目的观察米索前列醇用于剖宫产预防产后出血的效果。方法选择１８２例剖宫产者,随机分为米索前列醇组、米索前列醇＋催产素组及催产素组。米索前列醇组６０例,术中打开腹膜时口服米索前列醇６００μｇ。米索前列醇＋催产素组６４例,术中打开腹膜时口服米索前列醇６００μｇ,胎儿娩出后宫体肌内注射催产素２０ＩＵ。催产素组５８例,胎儿娩出后宫体肌内注射催产素２０ＩＵ,再静脉滴注催产素２０ＵＩ。以上各组观察术中及术后２小时内出血量。结果术中及术后２小时平均出血量,米索前列醇组为２１２±５６０ｍｌ;米索前列醇＋催产素组为２０８±５５４ｍｌ;催产素组为３４５±６４７ｍｌ。米索前列醇组与催产素组比较,差异有极显著性（Ｐ＜００１）。米索前列醇组与米索前列醇＋催产素组比较,差异无显著性（Ｐ＞００５）。结论米索前列醇促进子宫收缩作用强于催产素,能较好地预防剖宫产术后出血,且用药方便、安全。

Clinical study on reduction of postpartum bleeding in cesarean section by misoprostol

OBJECTIVE: To observe the effects of misoprostol on reduction of postpartum bleeding in cesarcan section. METHODS: One hundred and eighty-two cesarean sections were randomized into three groups: misoprostol group (n = 60), 600 micrograms misoprostol was given orally when peritoneum was incised; misoprostol and oxytocin group (n = 64), 600 micrograms misoprostol was given orally and 20 IU oxytocin was injected into uterine muscle immediately after delivery of baby. Oxytocin group (n = 58), 20 IU oxytocin was injected into uterine muscle and 20 IU intravenous injection immediately after delivery of baby. The amount of bleeding within 2 hours after delivery was measured. RESULTS: The mean amount of bleeding in misoprostol group was 212 +/- 56.0 ml, in misoprostol and oxytocin group was 208 +/- 55.4 ml, oxytocin group was 345 +/- 64.7 ml, respectively. The difference was significant P < 0.01 between misoprostol group and oxytocin group, there was no differences between misoprostol group and misoprostol plus oxytocin group. CONCLUSION: Misoprostol is more effective in reduction of postpartum bleeding than that of oxytocin.