小剂量米索前列醇加催产素预防产后出血临床观察

CLINICAL EFFECT OF LITTLE DOSE OF MISOPROSTOL WITH OXYTOCIN TO PREVENT POSTPARTUM HEMORRHAGE

目的观察小剂量米索前列醇直肠内给药配伍催产素预防产后出血效果。方法选择有产后出血危险因素的产妇188名,随机分成3组(即研究组和两对照组)进行临床对照观察。研究组在胎儿娩出后立即肌注催产素20U同时给予产妇直肠内放置米索前列醇0.2mg;对照1组在胎儿娩出后给产妇口服米索前列醇0.4mg;对照组2组在胎儿娩出后给产妇静脉点滴催产素20u+5%葡萄糖250ml。结果研究组用药后3～6min宫缩加强,持续3小时之久,产后2小时和24小时出血量均明显少于对照组,解决了产后2小时出血危险的难题。产后出血率、产褥患病率和输血率明显低于对照组,同时也减少了口服米索前列醇的副反应。结论小剂量米索前列醇加催产素能较好地预防产后出血,且用药简便、安全,具有广泛的应用价值。

Objective To observe the efficacy of little dose of Misoprostol by rectal medication with Oxytocin to prevent postpartum hemorrhage. Methods 188 puerperants in danger of postpartum hemorrhage were divided randomly into 3 groups （treatment group, control group 1 and control group 2）to observe. Puerperants in treatment group were medicated in rectum with 0.2mg Misoprostol combined with 20u Oxytocin intramuscular injection as soon as fetus delivery , puerperants in control group 1 were medicated with oral 0.4 mg Misoprostol after fetus delivery , and puerperants in control group 2 were medicated in vein with 20u Oxytocin and 250 ml 5% Glucose after fetus delivery. Results Uterine contraction strengthened after medication 3 to 6 minutes and lasted for 3 hours in treatment group, in which the amount of postpartum hemorrhage in 2 hours and 24 hours was obviously less than the control group . It solve the problem of the danger in 2 hours postpartum hemorrhage, Postpartum henurrhage rate , puerperal morbidity rate, blood transfusion rate and side reaction of oral Misoprostol in the treatment group were obviously less than the control group. Conclusion Little dose of Misoprostol with Oxytocin can prevent postpartum hemorrhage better and was medicated conveniently and safely. It is worth to popularizing in clinical application.