米索前列醇不同给药方式对产后出血患者总出血量及不良反应的影响

目的 探讨口服米索前列醇及直肠放置米索前列醇对产后出血患者总出血量及不良反应的影响。方法 选择本院2018年3月—2019年3月收治的80例产后出血患者作为研究对象,采用随机数表法分为对照组和观察组,每组各40例。2组产妇在分娩后24 h内注射10 U缩宫素+10%葡萄糖液20 mL,1次;对照组以口服方式含服200 μg米索前列醇,12 h内可根据出血量控制效果重复使用;观察组24 h内将200 μg米索前列醇放置产妇直肠内,1次。观察2组临床疗效、产妇产后2 h及24 h出血量、不良反应。结果 观察组总有效率(95.00%)略高于对照组(90.00%),但差异无统计学意义(P>0.05);观察组产后2 h出血量(126.31±7.97)mL、产后24 h出血量(245.57±9.35)mL略少于对照组,但差异无统计学意义(P>0.05);观察组不良反应发生率(7.50%)低于对照组(25.00%),差异有统计学意义(χ2=4.501,P=0.034)。结论 口服米索前列醇及直肠放置米索前列醇对产后出血治疗效果相当,均能减少产后出血量,但相较于口服给药,直肠给药不良反应发生率更低,用药安全性更高。

Effects of different administration methods of misoprostol on total bleeding volume and adverse reactions in patients with postpartum hemorrhage

Objective To investigate the effects of oral misoprostol and rectal misoprostol on total bleeding volume and adverse reactions in patients with postpartum hemorrhage. Methods A total of 80 patients with postpartum hemorrhage treated in a hospital from March 2018 to March 2019 were randomly divided into a control group (n=40) and a trial group (n=40). The parturients in two groups were injected with 10 U oxytocin and 10% glucose solution 20 mL once within 24 hours after delivery, while the parturients in the control group were given 200 μg misoprostol by oral administration, which could be reused within 12 hours according to the effect of bleeding volume, and the parturients in the trial group were given 200 μg misoprostol placed in the rectum once within 24 hours. The clinical effects, the amount of postpartum bleeding in 2 hours and 24 hours after delivery, and the adverse reactions of two groups were investigated. Results The total effective rate in the trial group (95.00%) was slightly higher than that in the control group (90.00%), but the difference was not statistically significant (P>0.05). The amount of postpartum bleeding in the trial group was (126.31±7.97) mL in 2 hours and (245.57±9.35) mL in 24 hours, which were slightly lower than those in the control group , but the difference was not statistically significant (P>0.05). The incidence of adverse reactions in the trial group (7.50%) was significantly lower than that in the control group (25.00%, χ2=4.501, P=0.034). Conclusion The oral misoprostol and rectal misoprostol are effective in the treatment of postpartum hemorrhage, and can reduce the amount of postpartum hemorrhage, but compared with the oral administration, the incidence of adverse reactions of rectal administration is lower and the safety of the treatment is higher.