雌激素辅助治疗产后出血的临床价值

目的探讨雌激素对宫缩乏力性产后出血的临床治疗效果。方法选择宫缩乏力性产后出血病例112例,随机分为实验组(52例)和对照组(60例),实验组在常规促宫缩治疗后随即肌肉注射苯甲酸雌二醇4mg,容积法计算产后出血量。结果(1)胎儿娩出后2h出血量比较:实验组产后出血量平均为(589.6±226.4)ml,明显低于对照组(864.5±359.5)ml(P<0.05);(2)胎儿娩出后2-24h出血量比较:实验组平均出血量(110.8±76.2)ml,对照组(剔除3例子宫切除病例)(161.5±98.3)ml,二者比较无显著性差异;(3)实验组未发生子宫切除病例,对照组子宫切除3例;(4)两组产妇和新生儿均未出现明显副作用。结论雌激素配合促宫缩药物治疗宫缩乏力性产后出血,对促进子宫收缩可发挥一定的协同作用,具有临床应用价值。

Clinical value of adjuvant therapy with estrogen for postpartum hemorrhage

OBJECTIVE: To investigate the clinical efficacy of estrogen in management of postpartum hemorrhage due to uterine atony. METHODS: Totalling 112 puerperants with postpartum hemorrhage due to uterine atony were randomly assigned into 2 groups and received routine managements for uterine atony such as uterine massage and uterotonics administration. The puerperants in one group (n=52) was treated with 4 mg estradiol benzoate injected intramuscularly, and the amount of blood loss 2 h after delivery and between 2 and 24 h after delivery was recorded. RESULTS: There were significant differences in vaginal blood loss at 2 h after delivery between the 2 groups (P<0.05). The puerperants with estrodiol benzoate treatment had blood loss of 589.6-/+226.4 ml at 2 h and 110.8-/+76.2 ml within 2-24 h after delivery, which were both less than those in the control group (864.5-/+359.5 ml and 161.5-/+98.3 ml, respectively). Postpartum hysterectomy was performed in 3 cases of the control group while none in estradiol benzoate-treated group. In the mothers and neonates, no major adverse effects were observed. CONCLUSION: Estrogen shows cooperative efficacy with uterotonics in stimulating uterine contraction for managements of postpartum hemorrhage due to uterine atony, and can be of value in clinical application.