米索前列醇预防剖宫产术后出血的临床观察

目的:观察米索前列醇用于预防剖产术后出血的疗效和安全性。方法:将2005年7月～2009年7月三亚市人民医院剖宫产产妇1 260例随机分为观察组620例和对照组640例,观察组于胎娩出后宫体注入缩宫素20 U,并于剖宫产缝合皮肤后立刻肛门放置米索前列醇0.2 mg加强宫缩。对照组仅于胎儿娩出后宫体注入缩宫素20 U,比较两组术后22、4 h出血量、产后出血率。结果:观察组产后2 h平均出血量(147.4±30.3)mL2、4 h平均出血量(308.5±35.3)mL与对照组产后2 h平均出血量(184.1±40.5)mL、24 h平均出血量[(486.3±38.4)mL]相比差异均有统计学意义(P均(0.05),观察组产后出血率(2.58%)较对照组(9.84%)明显降低(P(0.05)。结论:米索前列醇促进子宫收缩作用明显,能很好预防剖宫产术后的出血,不良反应少,用药方便、安全,值得临床推广。

Prevention effects of misoprostol on hemorrhage in cesarean section

Objective： To observe the efficacy and safety of misoprostol in preventing postoperative bleeding.Methods： A total of 1 260 parturient that underwent abdominal delivery during July 2005 and July 2009 in Sanya People＇s Hospital were randomly divided into observation group（620 cases） and control group（640 cases）.For both groups,20U oxytocin were injected into the uterine body after expulsion of the baby,while only the observation group was given a dose of 0.2 mg misoprostol by anus right after skin suture was finished.Compare the bleeding volume and the incidence of postpartum hemorrhage 2 and 24 hours after delivery.Results： For the observation group,average bleeding volume 2 and 24 hours after delivery were（147.4±30.3）mL,and（308.5±35.3） mL,significant less than the corresponding（184.1±40.5）mL and（486.3±38.4）mL of the control group（P both0.05）.The incidence of postpartum hemorrhage was 2.58 %,which was significant lower than the 9.84% of the control group（P0.05）.Conclusions： With few side effects,and great safety,misoprostol can promote uterine contraction and prevent postpartum hemorrhage effectively.