欣母沛联合马来酸麦角新碱治疗经阴道分娩产后出血临床观察

Clinical observation of hemabate combined with ergonovine maleate in the treatment of postpartum hemorrhage after vaginal delivery

目的产后出血为产科较为常见产后并发症,单纯使用促进宫缩药物有较大局限性,马来酸麦角新碱主要用在产后或流产后预防和治疗由于子宫收缩无力或缩复不良所致产后出血。本研究探讨欣母沛联合马来酸麦角新碱对经阴道分娩产后出血的临床效果。方法选择2018-05-31-2019-03-30甘孜藏族自治州人民医院收治的80例经阴道分娩后宫缩乏力所致大出血者作为研究对象,按照年龄和孕周等因素均衡的原则分为两组,各40例。对照组使用欣母沛联合缩宫素治疗,观察组使用欣母沛联合马来酸麦角新碱治疗。比较两组生产后24h内经阴道总出血情况、临床止血时间及治疗过程中出现的并发症,并在产后14d,进行超声检查,比较两组患者子宫前后径情况。结果产后2h,观察组出血量为(436.5±21.4)mL,少于对照组的(612.9±35.1)mL,t=27.139,P<0.05;产后24h,观察组出血量为(645.5±25.1)mL,少于对照组的(829.6±38.5)mL,t=25.333,P<0.05。观察组临床止血时间为(11.8±1.9)h,早于对照组的(25.2±3.5)h,t=21.281,P<0.05。观察组并发症发生率为10.0%,低于对照组的37.5%,χ~2=6.903,P=0.009。产后2周,观察组子宫前后径为(62.1±3.1)mm,小于对照组的(76.4±5.7)mm,t=13.939,P<0.05。结论针对产后出血者,应用欣母沛联合马来酸麦角新碱,具有较理想的止血效果,安全性高,且利于促进产后子宫复旧。

OBJECTIVE Postpartum hemorrhage is a common postpartum complication in obstetrics.The use of uterine contraction-promoting drugs alone has great limitations.Ergonovine maleate is mainly used to prevent and treat postpartum hemorrhage caused by uterine contraction weakness or poor contraction after abortion.The purpose of this study is to investigate the clinical effect of hemabate combined with ergonosine maleate on postpartum hemorrhage after vaginal delivery.METHODS A total of 80 cases of massive hemorrhage caused by uterine atony after vaginal delivery in the People′s Hospital of Ganzi Tibetan Autonomous Prefecture from May 31,2018 to March 30,2019 were selected as the study subjects.They were divided into two groups according to the principle of balanced age and gestational age,with40 cases in each group.The control group was treated with hemabate combined with oxytocin,while the observation group was treated with hemabate combined with ergonosine maleate.The total transvaginal hemorrhage,clinical hemostasis time and complications in the course of treatment within 24 hours after delivery were compared between the two groups.Ultrasound examination was performed 14 days after delivery to compare the anterior and posterior uterine diameters of the two groups.RESULTS The bleeding volume of the observation group was(436.5±21.4)and(645.5±25.1)ml respectively 2 hours and 24 hours after delivery,which were significantly lower than those of the control group(612.9±35.1)and(829.6±38.5)ml,t values were 27.139 and 25.333,both P<0.05.The clinical hemostasis time in the observation group was(11.8±1.9)h,earlier than that in the control group(25.2±3.5)h,t=21.281,P<0.05.The incidence of complications in the observation group was 10.0%,lower than 37.5%in the control group,χ~2=6.903,P=0.009.Two weeks after delivery,the anterior and posterior diameter of uterus in the observation group was(62.1±3.1)mm,which was smaller than that in the control group(76.4±5.7)mm,t=13.939,P<0.05.CONCLUSION Forpostpartum hemorrhage patients,hemabate combined with ergonovine maleate has ideal hemostatic effect and high safety,and it can actively promote postpartum uterine involution.