米索前列醇联合葡萄糖酸钙预防产后出血的临床疗效观察

目的探讨米索前列醇联合葡萄糖酸钙预防产后出血的临床疗效。方法选择2008年1～12月在本院分娩的120例产妇，均为足月妊娠、正常分娩、无妊娠合并症或并发症、未使用过前列腺素抑制剂的自然临产产妇，随机分为米索前列醇联合葡萄糖酸钙组（研究组）和缩宫素组（对照组），于第3产程早期分别给予口服米索前列醇、静脉注射葡萄糖酸钙或肌注缩宫素，计算第3产程时间，测量胎盘娩出时、产后2h和24h出血量，监测产妇产后的血压、脉搏、呼吸、血氧饱和度和不良反应。结果研究组的第3产程时间、胎盘娩出时出血量、产生2h出血量和产后24h出血量显著低于对照组，两组差异有统计学意义（P〈0．05）．研究组产后2h出血量1〉400ml和产后24h出血量≥500ml的比率显著低于对照组，两组差异有统计学意义（P〈0．05）。研究组用药前后的收缩压、舒张压、脉膊、呼吸和血氧饱和度差异无统计学意义（P〉0．05）。结论米索前列醇联合葡萄糖酸钙能起到加强子宫肌收缩，预防产后出血的效果，是一种操作简便、止血好、性能安全、有临床使用价值的方法。

The clinical effect of a combined treatment of postpartum haemorrhage with misoprostol and calcium gluconate

Objective To explore the clinical effect of a combined treatment of postpartum haemorrhage with misoprostol and calcium gluconate. Methods 120 normal parturients who were pregnancy at term, normal delivery, no pregnancy complications, no use of prostaglandin inhibition were randomized into groups ： misoprostol with calcium gluconate group and oxytocin group respectively oral misoprostol and calcium gluconate with intravenous injection, oxytocin with intramuscular injection in the early third stage of labour, then the time of the third stage of labour was calculated, also the mount of bleeding at the time of placental expulsion, within 2h and 24h after delivery were measured. At the same time, blood pressure, pulse, the frequency of respiration, saturation of blood oxygen, sideeffect were observed in misoprostol with calcium gluconate group before and after administration. Results The time of the third stage of labour, the mount of bleeding within 2h and more than 500ml wihin 24h in the misoprostol ＋ calcim gluconate group were less than that of oxytocin group（ P 〉 0.05）. Conclusion Oral administration of misoprostol and intravenous drip of calcium gluconate could strenghen and increase womb systole frequncy and stop postpartum haemorrhage, it is a simple , safe, convenient, chinical valueble to postpartum haemorrhage.