钙与宫缩乏力和剖宫产产后出血的研究

目的探讨钙水平与宫缩乏力的关系，以及应用钙剂减少剖宫产宫缩乏力性产后出血的临床效果。方法选择平产分娩的产妇100例，测定血钙的水平，比较不同水平钙对宫缩的影响；选择择期剖宫产产妇200例，随机分为试验组及对照组各100例，试验组于术前开放静脉通道后，于莫非氏管内静滴50％葡萄糖30mL加10％葡萄糖酸钙10～20mL，对照组仅常规开放静脉通道。观察术中、术后24h的出血量。结果（1）低钙组有21例，宫缩乏力者9例，发生率占43％，产后出血量（385±35）mL，与正常钙组和高钙组比较，差异有显著性意义（P〈0．01）；（2）实验组出血量（200±32）mL，≥500mL者2例（2％）；对照组出血量（330±35）mL，≥500mL者19例（19％），两组比较，出血量和产后出血率差异有显著性（P〈0．01）。结论保持正常水平钙可以有效减少及预防宫缩乏力引起的产后出血；剖宫产术前补钙，对预防宫缩乏力引起的产后出血有良好的效果，利于术后康复，节约血源，值得临床推广。

Study of the Effect of Calcium on Inefficient Uterine Action and Postpartum Hemorrhage in Uterine-incision Delivery

Objective To study the effect of serum calcium on inefficient uterine action and to estimate the validity of using calcium before uterlne-incision delivery. Methods 100 cases of primiparae were divided into three groups according to the level of serum calcium; 200 cases of puerpera of uterine-incision delivery were divided into control group and study group randomly. Study group were vein intravenous dripped with 10mL of 10% calcium gluconate. Collected and recorded the amount of hemorrhage after 24 hours of postpartum. Results （ 1 ）The group of low level of calcium was 21 cases,9 cases of them were inefficient uterine action,and had much higher possibility of hemorrhage than that of the normal level of serum calcium（P 〈 0.01 ）. （2）The amount of bleeding in study group was（200 ± 32）mL, the amount of bleeding in control group was（330 ± 35 ）mL, it was significantly different between the two groups（P 〈 0.01 ）. Conclusion A normal level of serum calcium plays an important role in preventing postpartum hemorrhage. Application of calcium can reduce postpartum hemorrhage effectively before uterine-incision delivery.