米索前列醇宫腔放置预防前置胎盘剖宫产术出血的临床观察

Effect of placing misoprostal into uterine cavity for prevention of hemorrhage of cesarean section in patients with previa placenta

目的:观察宫腔放置米索前列醇预防前置胎盘剖宫产术后出血的效果。方法:选择52例前置胎盘剖宫产术者,随机分为两组,试验组30例,应用子宫下段放置米索前列醇+催产素宫体注射+子宫下段明显血窦肠线"8"字缝合,对照组22例应用催产素宫体注射+子宫下段明显血窦肠线"8"字缝合,以上两组观察术后2 h内出血量。结果:试验组术后出血量(710±150)mL,≥500 mL 6例,占全部病例23.08%,≥1 000 mL 2例,占57.69%。对照组术后出血量(992±309)mL,≥500 mL 19例,占全部病例3.08%,≥1 000 mL 6例,占23.07%,两组出血量比较,有显著性差异(P<0.01)。结论:应用米索前列醇放置宫腔+催产素宫体注射,促进子宫收缩作用,明显强于单纯应用宫体注射催产素,能较好地预防前置胎盘剖宫产术后出血,用药安全、方便、有效。

Objective： To observe the effect of prevention of postpartum hemorrhage by placing misoprostal into uterine cavity in patients with previa placenta underwent cesarean section. Methods： Fifty two patients with previa placenta underwent cesarean section were divided two groups with randomization. Group of subject had 30 patients, managed with placing misoprostal in inferior uterine cavity ＋ injecting oxytocin into body of uterus ＋ suturing placenta blood sinus of inferior uterus with catgut thread in 8＇pattern; group of control had 22 patients, managed with injecting oxytocin into body of uterus ＋ suturing placenta blood sinus of inferior uterus with catgut thread in 8＇pattern. Volume of postpartum hemorrhage were observed for 2 hours after cesarean section. Results： Volume of postpartum hemorrhage in group of subject was （710 ±150）mL, among them, volume in 6 patients≥ 500 mL, account for 23.08% of total ; volume in 2 patients ≥ 1 000 mL, account for 57.69%. Volume of postpartum hemorrhage in group of control was （992 ± 309 ） mL, among them, volume in 19 patients ≥500 mL, account for 3.08 % of total; volume in 6 patients≥1000 mL, account for 23.07%. There was significant difference comparing the volume of blood loss in the two groups （P 〈 0. 01 ）. Conclusions： Combined use of misoprostal and oxytocin for patients with previa placenta underwent cesarean section can enhance uterine contraction great stronger than that using oxytocin alone; it can prevent effectively postpartum hemorrhage; it＇s safety, ready available and effective.