宫缩乏力性阴道分娩产后出血卡孕栓联合钙剂的预防效果分析

目的观察宫缩乏力性阴道分娩产后出血应用卡孕栓联合钙剂进行预防的临床效果。方法济源市人民医院2008年10月至2012年10月进行引导分娩的792例产妇，依据治疗方法将其随机分为实验组（400例）与对照组（392例），对照组在胎儿娩出后予以20U缩宫素静脉输注，实验组在胎头拔露时予以10ml葡萄糖酸钙静脉快速输注，在胎儿娩出后1枚卡孕栓立即置入直肠，观察两组产后2h内与2—24h和24h内总出血量及产后出血发生率和不良反应情况。结果产妇产后24h分段收集失血量资料显示，实验组与对照组相较，呈显著差异（P〈0．01），将24h内产妇出血量500ml作为产后出血判定标准，实验组42例（10．5％），平均失血量为（439．26±75．28）ml，对照组72例（18．4％），平均失血量为（572．85±81．63）ml，两组相较，呈明显差异（P〈0．05），实验组产妇共10例（2．5％）发生面部潮红，但均能耐受，可自行在短时间内消失，有4例（4．0％）出现恶心、呕吐及腹泻症状，而对照组共6例（1．5％）出现恶心、呕吐及腹泻等症状，6例（1．5％）出现心率加快，12例（3．1％）出现浮肿症状，18例（4．6％）出现面部的潮红表现。结论宫缩乏力性阴道分娩产后出血，在胎头拔露时应用卡孕栓联合钙剂进行预防，能够减少产妇产后出血及不良反应的出现，应予推广。

Analysis of preventive effect of carboprost combined with calcium uterine atony postpartum hemorrhage in vaginal delivery

Objective To observe the postpartum vaginal delivery postpartum hemorrhage prevention of Carprost com- bined with calcium agent. Methods Retrospective analysis of our hospital from 2008 October to 2012 October, to guide the clinical data 792 lying in women in our department, according to the methods of treatment were randomly divided into experimental group （n =400） and control group （n =392）, the control group after the delivery of fetus to 20U Sujing vein infusion of oxytocin, the experimental group in the fetal head exposed to 10 ml calcium gluconate intravenous infu- sion, placed immediately after the dehvery of fetus 1 methyl carprost suppository rectal, two groups of postpartum within 2 h with 2- 24h and 24h within the total amount of bleeding, and the two groups the incidence of postpartum hemorrhage were observed, and observe the occurrence of adverse reactions of two groups the situation. Results The maternal post- partum blood loss 24h collected data, the experimental group compared with the control group, with significant difference （P 〈0. 01 ）, 24 h in maternal blood loss was 500 ml as the criterion of postpartum hemorrhage, 42 cases of the experi- mental group （ 10. 5% ）, the average blood loss was （439. 26 ±75.28） ml, the control group in 72 cases （ 18.4% ）, the average blood loss was （572. 85 ±81.63） ml, two groups compared, is significantly difference （P 〈0. 05）, the ex- perimental group had a total of 10 patients （2. 5% ） had facial flushing, but tolerated, can disappear in a short time, there were 4 cases （4%） nausea, vomiting and diarrhea, while the control group were 6 cases （1.5%） nausea, vomi- ting and diarrhea and other symptoms, a total of 6 cases （ 1.5% ） in heart rate up, a total of 12 cases （3.1%） ap- peared the symptoms of edema, 18 cases （4. 6% ） occurred flushing performance face. Conclusion Uterine atony post- partum hemorrhage in vaginal delivery, the fetal head pull dew of Carprost combined with calcium for prevention, not on- ly can reduce postpartum hemorrhage, and can reduce the adverse reactions of patients, significant effect, should be popularized.