高危产妇产后出血的防治

目的:探讨不同药物用于预防和治疗产后出血的临床疗效和安全性。方法:选取2006年6月～2011年6月因多胎妊娠、巨大胎儿、前置胎盘、胎盘早剥、羊水过多等有高危因素的产妇,计划剖宫产者1 380例随机分为3组,A组:胎儿娩出后宫体注入缩宫素20U,若有出血倾向者,加大缩宫素剂量,最大剂量80U;B组:胎儿娩出后宫体注入缩宫素20U,并于剖宫产术中胎盘娩出后擦拭宫腔后将米索前列醇片200μg置放宫腔底部,若有出血倾向者,给予嚼服或直肠给予米索前列醇片,最大剂量600μg;C组:胎儿娩出后宫体注入缩宫素20U+欣母沛250μg,若有出血倾向者,加大欣母沛剂量,最大剂量750μg,对3组资料进行回顾性分析。结果:预防性用药C组比A组、B组术后2h及术后24h出血量显著减少(P<0.01)。治疗性用药产后出血发生率明显低于A组、B组(P<0.05),治疗有效率明显高于A、B两组(P<0.05)。结论:欣母沛能很好预防高危产妇的产后出血发生率,治疗宫缩乏力性产后出血的效果明显,大大减少了切除子宫的危险,值得临床推广应用。

Prevention and treatment of postpartum hemorrhage in high risk parturients

Objective: To explore the effectiveness and safety of different drugs in prevention and treatment of postpartum hemorrhage in high risk parturients.Methods: A total of 1 380 high risk parturients admitted from June 2006 to June 2011 in our hospital because of multiple pregnancy,fetal macrosomia,placenta previa,placental abruption,polyhydramnios,were selected and randomly divided into 3 groups.Parturients in group A received oxytocin 20U after delivery.The dosage was increased if patients tended to bleeding....