剖宫产术中胎盘剥离方式以及不同剂量缩宫素对产妇的影响研究

目的：探讨剖宫产术中胎盘剥离方式以及不同剂量缩宫素对产妇的影响。方法将2011年7月至2012年7月于本院产科行剖宫产术的产妇110例随机分为 A组与 B组,各55例。A组产妇在胎儿娩出后给予缩宫素10 IU肌肉注射及缩宫素10 IU静脉滴注;B组产妇在胎儿娩出后给予缩宫素20 IU肌肉注射及缩宫素20 IU静脉滴注。比较两组产妇术中出血量、手术时间、输液量、血压及心率的变化以及药物不良反应。根据胎盘剥离方式,将 A组、B组产妇随机分为自然剥离组与人工剥离组,各30例,比较术中出血量。结果用药后5 min,A、B两组产妇收缩压（SBP）、舒张压（DBP）均较用药前降低,心率升高,且 B组 SBP、DBP下降程度较 A组更为明显（P＜0．05）,但两组心率比较差异无统计学意义（P＞0．05）;用药后10 min,两组产妇 SBP、DBP、心率均升高,且 B组SBP、DBP、心率升高程度较 A组更为明显（P＜0．05）。人工剥离组产妇术中出血量为（147＆#177;44）mL,多于自然剥离组[（126＆#177;35）mL],组间比较差异有统计学意义（P＜0．05）。结论剖宫产术中采用胎盘自然剥离能够有效减少产妇术中出血量,缩宫素的使用剂量宜采用最低有效剂量。

Effect of different cesarean section methods and oxytocin dosages on puerperants

Objective To investigate the effect of different cesarean section methods and oxytocin dosage on puerperants.Methods A total of 110 cases of puerperants undertaken cesarean section from July 2011 to July 2012 in this hospital were randomly divided into Group A and Group B,with 5 5 cases for each group.Puerperants in Group A were treated with intramuscular injection of oxytocin 10 IU and intravenous drip of oxytocin 10 IU after delivery.Pu-erperants in Group B were treated with intramuscular injection of oxytocin 20 IU and intravenous drip of oxytocin 20 IU after delivery.The amount of bleeding,operation time,amount of transfusion,blood pressure,heart rate and ad-verse drug reactions were compared between the two groups.At the same time,puerperants in Group A and Group B were randomly divided into natural placenta peeling group and artificial placenta stripping group,with 30 cases for each group,and amount of bleeding was compared.Results Five minutes after administration,systolic blood pressure （SBP）and diastolic blood pressure （DBP）in puerperants of the two groups were decreased,and heart rate was in-creased.And the decreasing of SBP and DBP in Group B were more significant than Group A （P＆lt;0.05）,but the difference of heart rate was not significant （P＆gt;0.05）.Ten minutes after administration,SBP,DBP and heart rate in the two groups were increased,and the increasing of SBP,DBP and heart rate in Group B were more significant than Group A （P＆lt;0.05）.The amount of bleeding in artificial placenta stripping group was （147＆#177;44）mL,more than nat-ural placenta peeling group [（126＆#177;35）mL],with significant difference between the two groups （P＆lt;0.05）.Conclu-sion Natural placenta peeling in cesarean section could effectively reduce the amount of blood loss during operation, and the lowest effective dosage of oxytocin might be more suitable.