缩宫素不同给药方式对剖宫产产妇的影响

Effects of Different Administration Method of Oxytocin on Parturients in Cesarean Section

目的:观察缩宫素不同给药方式对剖宫产产妇的影响。方法:选取2021年2月—2023年2月厦门大学附属第一医院杏林分院收治的216例剖宫产产妇为研究对象。随机将其分为A组、B组和C组,各72例。三组均进行剖宫产,A组子宫肌内注射缩宫素,B组静脉滴注缩宫素,C组静脉滴注+莫非氏滴管注射缩宫素。比较三组产后出血情况,用药前及用药后10 min血流动力学指标,术前及术后24 h炎症因子及不良反应。结果:C组产后出血发生率和产后出血量均低于A组和B组,差异有统计学意义(P<0.05)。用药后10 min,C组收缩压、舒张压、心率、心排出量(cardiac output,CO)、心脏指数(cardiac index,CI)、平均动脉压(mean arterial pressure,MAP)均高于A组及B组,差异有统计学意义(P<0.05)。术后24 h,C组肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-6(interleukin-6,IL-6)水平均低于A组及B组,白细胞介素-4(interleukin-4,IL-4)、白细胞介素-10(interleukin-10,IL-10)均高于A组及B组,差异有统计学意义(P<0.05)。三组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:静脉滴注+莫非氏滴管注射缩宫素式可降低剖宫产患者产后出血量与产后出血率,改善产妇血流动力学。

Objective:To observe the effects of different administration method of Oxytocin on parturients undergoing cesarean section.Method:A total of 216 parturients undergoing cesarean section in Xinglin Branch of the First Affiliated Hospital of Xiamen University from February 2021 to February 2023 were selected as the study objects.They were randomly divided into group A,group B and group C,with 72 cases in each group.Cesarean section was performed in all three groups,group A was given uterus intramuscular injection of Oxytocin,group B was given intravenous infusion of Oxytocin,and group C was given intravenous infusion+Murphy's dropper uterus of Oxytocin.Postpartum hemorrhage condition,hemodynamic indexes before and 10 min after medication,inflammatory factors before and 24 h after surgery,and adverse reactions were compared among the three groups.Result:The incidence of postpartum hemorrhage and amount of postpartum hemorrhage in group C were lower than those in group A and group B,and the differences were statistically significant(P<0.05).At 10 min after medication,systolic blood pressure,diastolic blood pressure,heart rate,cardiac output(CO)and cardiac index(CI),and mean arterial pressure(MAP)of the C group were higher than those of group A and group B,and the differences were statistically significant(P<0.05).At 24 h after surgery,the levels of tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)in group C were lower than those in group A and group B,and the levels of interleukin-4(interleukin-4)and interleukin-10(IL-10)were higher than those in group A and group B,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions among the three groups(P>0.05).Conclusion:Intravenous infusion+Murphy's dropper uterus of Oxytocin can reduce the amount of postpartum bleeding and the rate of postpartum bleeding in parturients with cesarean section,improve the hemodynamics.