产后出血量与缩宫素使用时间的关系

目的：研究产后出血量与缩宫素使用时间关系,以便选择预防产后出血的最佳方法。方法：选择2007-07/2007-12本院阴道分娩的无妊娠合并症或并发症的产妇200例,随机分为A、B两组,每组100例。A组于胎儿前肩娩出后臀部肌内注射缩宫素20 U;B组于胎儿胎体完全娩出后臀部肌内注射缩宫素20 U。观察比较两组第三产程阴道出血量。结果：第三产程阴道出血量A组较B组明显减少,有统计学差异（P〈0.01）;第三产程出血量大于200 ml的发生率A组明显低于B组,有统计学差异（P〈0.05）。结论：胎儿前肩娩出后常规使用缩宫素可减少产后出血量,降低产后出血的风险。     

卡孕栓合用缩宫素预防产后出血的疗效观察

目的观察卡孕栓合用缩宫素预防产后出血的临床疗效。方法将我院2004年1月~2005年2月对350例正常足月阴道分娩的产妇随机分为两组。观察组:175例,于胎儿娩出后肌注缩宫素20U,并舌下含服卡孕栓1mg;对照组:175例,于胎儿娩出后单独肌注缩宫素20U。观察第三产程时间、产后2h阴道出血量及产后出血率。结果观察组第三产程时间为(7±3)m in,产后2h阴道出血量为(170±84)m l,产后出血率2.3%;对照组第三产程时间为(10±4)m in,产后2h阴道出血量为(257±98)m l,产后出血率7.4%,两组相比差异有统计学意义(P<0.01)。结论卡孕栓合用缩宫素促进宫缩,减少产后出血疗效满意,且使用方便、快速、安全。     

卡孕栓配伍缩宫素预防产后出血的临床观察

目的观察阴道分娩时卡孕栓配伍缩宫素预防产后出血的效果。方法 120例产妇随机分为3组,A组40例,B组40例,对照组40例。A组胎儿娩出后,立即舌下含化卡孕栓1mg,B组直肠给药卡孕栓1mg,同时3组产妇均给予静脉滴注缩宫素20U,对照组不再用其他药物;比较3组产妇产后2h出血量。结果观察A组与观察B组产后2h出血量均明显少于对照组(P<0.05)。观察A组与观察B组对减少产后出血无统计学差异(P>0.05)。结论卡孕栓配伍缩宫素对于预防产后出血有明显效果。     

探讨麦角新碱联合缩宫素治疗产后出血的临床效果

目的:探讨麦角新碱联合缩宫素治疗产后出血的临床效果。方法:80例产后出血患者为研究对象,采用数据库随机分组,观察组和对照组各40例,分别进行麦角新碱联合缩宫素治疗、缩宫素治疗,此项研究在2015年5月22日至2019年5月22日进行,随后对比两组宫底高度、出血量、不良反应发生率。结果:观察组产后1d宫底高度(18.86±1.75)cm、产后3d宫底高度(16.43±1.65)cm、产后5d宫底高度(13.23±1.52)cm、产后2h出血量(95.62±5.46)mL、产后4h出血量(125.23±8.95)mL、产后24h出血量(185.15±18.74)mL、不良反应发生率(2.50%)均优于对照组(P<0.05)。结论:对产后出血患者实施麦角新碱联合缩宫素治疗效果显著,可减少产后出血量。     

米索前列醇配合缩宫素预防产后出血316例临床观察

目的:观察米索前列醇配合缩宫素预防产后出血的效果.方法:选取我院足月妊娠且无妊娠并发症,近期内未使用前列腺制剂的自然分娩者626例,随机分为观察组(316例)、对照组(310例).对照组予胎儿前肩娩出后即注射缩宫素20 U;观察组注射缩宫素10 U,在胎儿娩出后1小时口服米索前列醇400 μg.观察两组第3产程时间、产后2小时出血量、产后出血率、血压的变化.结果:第3产程时间、产后 2小时出血量、产后出血发生率观察组分别为(8.2±3.5)分钟、(151.9±46.8)mL、0.6%,对照组分别为(12.9±3.9)分钟、(248.3±69.3)mL、4.0%,两组比较差异有统计学意义(P＜0.01).两组产后血压比较差异无统计学意义(P＞0.05).结论:米索前列醇配合缩宫素预防产后出血优于单用缩宫素,值得临床推广.     

卡孕栓配伍缩宫素预防镇痛分娩产后出血的应用

目的:观察卡孕栓配伍缩宫素用于预防镇痛分娩产后出血的临床效果。方法:将60例实施镇痛分娩的初产妇随机分为观察组和对照组各30例,观察组在胎头娩出后经舌下含服卡孕栓1枚(1 mg),并给予缩宫素20 U加入溶液中静滴;对照组常规从茂菲滴管内注入缩宫素20 U及加入溶液10 U静滴。观察两组患者产后2 h及产后24 h出血量。结果:观察组产后2 h出血量为(256±10.15)mL,对照组为(278±14.95)mL;观察组产后24 h出血量为(331±58.95)mL,对照组为(377±84.80)mL,两组比较差异均有显著性意义。结论:卡孕栓配合缩宫素应用促进子宫收缩作用明显,能很好预防产后出血,且用药方便、安全。     

阴道出血产妇使用卡前列素氨丁三醇联合缩宫素的止血效果的评估研究

目的探讨孕产妇阴道出血达500ml后使用卡前列素氨丁的止血效果。方法选择180例阴道出血达500ml的产后出血产妇,随机分为对照组和观察组各90例,对照组受试者行缩宫素治疗,观察组受试者卡前列素氨丁三醇联合缩宫素治疗。记录病比较两组受试者产后2、24h出血量、产后输血量以及止血时间。结果观察组受试者产后2、24h出血量以及产后输血量均显著低于对照组受试者(P0.05),两组间存在显著差异(P0.05);观察组受试者产后止血时间较对照组明显缩短(18.19±2.64 vs 35.63±4.71),两组间存在显著差异(P0.05)。结论在孕产妇阴道出血达到500ml后使用卡前列素氨丁三醇联合缩宫素治疗,可以有效降低产后出血量与输血量,缩短止血时间,效果优于单独行缩宫素治疗。     

益母草注射液联合缩宫素预防产后出血临床效果及对血压影响的观察

目的探讨益母草注射液联合缩宫素预防产后出血临床效果及对血压的影响。方法将2014年6至10月阴道分娩的产妇400例,随机分为A、B组,每组各200例。A组为益母草注射液与缩宫素联合用药,B组为单独使用缩宫素组。比较两组产后2 h、24 h出血量,注射益母草后患者血压变化情况及副作用。结果与B组比较,A组产后2h、24 h出血量及出血例数明显减少,副作用更少(P0.05),且患者血压无明显变化。结论益母草注射液+缩宫素预防产后出血效果明显优于单纯使用缩宫素,且无明显不良反应发生。     

应用缩宫素及米索前列醇预防产后出血的观察

目的观察应用缩宫素及米索前列醇预防产后出血的效果。方法 2009年1月~2010年12月在我科分娩中有产后出血高危因素的阴道分娩产妇200例,随机分为观察组和对照组,各100例。观察组在胎儿娩出后,立即肌注缩宫素10U,并将米索前列醇400μg放入直肠。对照组在胎儿娩出后常规肌注缩宫素10U,同时静滴缩宫素20U。观察产后2h内出血量、第三产程时间及产后出血发生率。结果两组产后2h内出血量、第三产程时间及产后出血发生率的比较有显著性差异(P<0.05)。结论应用缩宫素及米索前列醇预防产后出血疗效显著。     

米索前列醇联合缩宫素预防产后出血临床观察

目的:观察米索前列醇联合缩宫素用于预防产后出血的效果。方法:200例阴道分娩的足月产妇,分为米索前列醇联合缩宫素组及单用缩宫素组各100例。米索前列醇联合缩宫素组于胎儿娩出后即直肠给药米索前列醇600!g及宫颈注射缩宫素20IU。缩宫素组于胎儿娩出后即宫颈注射缩宫素20IU。结果:产后2小时内的出血量,观察组为(155±80)mL。对照组为(248±95)mL,3例发生产后出血。两组比较有显著性差异。结论:米索前列醇联合缩宫素比单用缩宫素具有更强的缩宫作用,用于预防产后出血效果显著,且用药方便、安全,值得推广应用。     

Prospective evaluation of a pediatric bleeding questionnaire and the ISTH bleeding assessment tool in children and parents in routine clinical practice

Summary. Background: Diagnosing mild bleeding disorders (BDs) in children is difficult. Bleeding scores (BSs) have been proposed for obtaining standardized quantitative histories. Objectives: To compare the Canadian pediatric bleeding questionnaire (PBQ) with the new ISTH bleeding assessment tool (ISTH BAT) for the determination of BS in a routine pediatric outpatient setting. Methods: One hundred children with a suspected BD were enrolled in this cross‐sectional study. Bleeding scores were calculated for all children and their natural parents. For all children, extensive laboratory investigations were performed. Results: Based on laboratory tests, 56 children were diagnosed as having no BD, 11 were diagnosed with possible VWD, 12 with VWD 1, 11 with VWD 2, five with possible platelet defects, and five with mild factor deficiencies. Both questionnaires were able to discriminate between no BD and VWD (P = 0.0001), but the area under the receiver characteristics curve to detect any mild BD was only 0.76. Despite the inherited nature of the BD, a family score did not increase the ability to discriminate between no BD and VWD (P = 0.2052). There was no significant difference between the two tools used (P = 0.3253) or simple qualitative criteria, such as yes/no questions regarding bleeding (P = 0.3477). Conclusions: The two tools translated into German did not differ substantially. Both were able to discriminate between no BD and a possible BD with acceptable accuracy. A BS of < 2 makes a BD unlikely. Simple qualitative criteria were similar; however, to allow comparison of studies and follow‐up in patients over time, we recommend the ISTH BAT.     

尿棘形红细胞在肾性和非肾性血尿鉴别中的意义

本文用相差显微镜对结晶紫－沙黄染色的２４例肾性出血和２１例非肾性出血尿沉渣各种形态红细胞进行观察和分类计数。结果,棘形红细胞在肾性出血红细胞总数中所占的比率（５．５％）远高于非肾性出血（０．６％）。表明棘形红细胞是区别肾性出血和非肾性出血有用的特征性标志物。     

A retrospective analysis of 157 surgical procedures performed without replacement therapy in 83 unrelated factor VII‐deficient patients

Summary. Background: Inherited factor (F)VII deficiency is the commonest of the rare bleeding disorders, with a wide set of hemorrhagic features. Other than for the severe clinical forms (for which treatment guidelines are well defined), consistent recommendations regarding perioperative replacement management do not exist for mild and asymptomatic FVII‐deficient patients. Objectives: The present study aimed to evaluate the influence of bleeding history, FVII procoagulant activity levels (FVII:C) and the type of surgical procedure on the management of inherited FVII‐deficient patients before surgery. Patients: One hundred and fifty‐seven surgical procedures, performed without replacement therapy, in 83 unrelated FVII‐deficient patients (median FVII:C = 5%, range 0.6%–35%) were analyzed. Results: The overall bleeding rate was 15.3%. We found a significant relationship between previous deep traumatic hematomas and bleeding at surgery, although relationships with previous common epistaxis, easy bruising and menorrhagia were not significant. The receiver‐operating characteristic (ROC) curve analysis performed on the first 83 procedures allowed us to define a cut‐off value of 7% with a sensitivity of 87% (negative predictive value: 94%). To enhance the sensitivity, and to take into account the potential variation resulting from non‐standardized FVII:C measurements, we would suggest applying a threshold of 10%. Conclusion: We have proposed recommendations for the perioperative management of FVII‐deficient patients based on FVII:C levels, a thorough bleeding history and the type of surgery involved. By applying these recommendations, minor procedures that risk only external or controlled hemorrhage can be performed in asymptomatic or mildly affected adults, even those with FVII:C levels below 10%.     

Use of vaginosonographic measurements of endometrial thickness in the identification of abnormal endometrium in peri- and postmenopausal bleeding

One hundred and seventy seven women with peri- and postmenopausal bleeding were subjected to vaginosonographic examination followed by thorough pathological examination of the uterine curetting samples. A mean endometrial thickness (double layer) of 13.2 ± 3.6 mm and 8.2 ± 4.8 mm were found in those with and without histological abnormalities, respectively. Endometrial thickness of less than 7 mm, however, was found to be predictive of normal endometrium (100% sensitivity, 46% specificity) and can, therefore, be used to separate those who require diagnostic curettage from those who do not. These findings suggest that this relatively simple, noninvasive procedure can be used as a screening test for patients with peri- or postmenopausal bleeding. © 1994 John Wiley & Sons, Inc.