米索前列醇预防产后出血的临床疗效观察

目的:探讨米索前列醇口服预防产后出血的疗效。方法:选择无米索前列醇禁忌,单胎头位经阴道分娩的485例孕产妇,随机分为三组:米索前列醇组205例,胎儿娩出后即予口服米索前列醇400μg;米索前列醇加缩宫素组148例,胎儿娩出后即予口服米索前列醇400μg,同时给予缩宫素10U肌注;缩宫素组132例,胎儿娩出后即予肌注缩宫素10U,同时静脉注射缩宫素10U,观察三组产妇第三产程时间、产时及产后出血量、产后24h出血总量、发生产后出血的例数。结果:第三产程时间、产时及产后出血量、产后24h出血总量、发生产后出血例数米索前列醇组与米索前列醇加缩宫素组比较,差异无显著性(P>0·05);米索前列醇组与缩宫素组比较,差异有极显著性(P<0·001),产后出血的发生率明显下降。同时口服米索前列醇无严重不良反应发生。结论:米索前列醇对预防阴道分娩时的产后出血效果良好,对子宫的收缩作用强于缩宫素,且用药方便、简单、经济、安全,值得推广。

Observation of clinical curative effect of misoprostol on preventing postpartum hemorrhage

Objective:To discuss the curative effect of misoprostol on preventing postpartum hemorrhage.Methods:485 puerperas without taboo of misoprostol and delivered through vagina, were chosen and divided into 3 groups: 205 puerperas in group misoprostol took 400 μg misoprostol orally after expulsed fetuses, 148 puerperas in group misoprostol+oxytocin took 400 μg misoprostol orally and intramuscular injection of 10 U oxytocin after expulsed fetuses simultaneously and 132 puerperas in group oxytocin took intramuscular injection and intravenous injection of 10 U oxytocin after expulsed fetuses respectively to observe the time of third stage labour, the bleeding volume of intrapartum, postpartum and 24 hours after delivery and the cases of postpartum hemorrhage.Results:The time of third stage labour, the bleeding volume of intrapartum, postpartum and 24 hours after delivery and the cases of postpartum hemorrhage had no significant differences (P>0. 05) between group misoprostol and group misoprostol+oxytocin. And the differences of them were significant between group misoprostol and group oxytocin (P<0.001). The incidence rate of postpartum hemorrhage declined evidently. At the same time there were no serious untoward reactions by taking misoprostol orally.Conclusion:The effect of misoprostol preventing postpartum hemorrhage is good. And its shrinking function is better than that of oxytocin. Also the misoprostol has the virtues of convenience, briefness, economy and safety. In a word, misoprostol is worth popularizing.