剖宫产术中用益母草注射液预防产后出血临床观察

目的:观察益母草注射液与缩宫素联合应用在剖宫产术中预防产后出血的疗效。方法:将200例施行剖宫产产妇随机分为两组,实验组和对照组各100例。实验组:剖宫产术中胎儿娩出第一把血管钳钳夹脐带后,立即宮壁注射益母草注2ml(40mg),切口上缘2ml(40mg)。同时静滴注射缩宫素20IU。术后2小时肌肉注射益母草注射液2ml(40mg),以后每12小时1次,2ml(40mg)/次,连续注射3～5天。对照组:采用常规静脉点滴缩宫素20IU。结果:①剖宫产术中益母草注射液注射后5分钟后观察结果。实验组:95例子宫收缩明显,切口出血明显减少,显效率95%;5例子宫收缩尚可,出血减少,有效率5%。无一例子宫收缩差,切口出血多的;无效率0%;对照组:显效率88%,有效率5%,无效率7%;两组之间存在着显著性差异(P<0.05)。治疗组无一例需再补充治疗性宫缩剂的、无其他损伤性手术干预措施的病例、没有出现需要输血的病例;对照组有7例需要给予治疗剂量宫缩剂,2例采用B-lynch缝合术。2例需要输血。②剖宫产后24小时出血情况的观察结果:产后24小时观察,在治疗组中90例,产后出血量非常少,效果明显,显效率90%;10例,产后出血量一般,有效率10%;产后出血量较多,效果不明显为0。总有效率100%。对照组83例后出血量非常少,效果明显,显效组为83%;15例产后出血一般,有效率15%,出血多者为2例(2%)。总有效率98%。③产前、产后48小时HCT变化:对200名测量了术前术后HCT值进行测量,治疗组术前平均HCT值为34.29,术后平均HCT值为31.2,差值3.09。对照组:术前为34.34,术后为31.16,差值2.98,两组差异无显著性。讨论:剖宫产术中缩宫素联合益母草注射液作为预防子宫收缩乏力性的出血,效果显著,可有效地防治产后出血的发生,本次观察表明,无需加入治疗性宫缩剂和其他有损伤性治疗,做到对母体的影响最小化。虽然经过其他治疗性的措施使得两组最后HCT的之间差别不大,但这种预防措施对母体的影响程度却可以最小化。

Objectives： observe effect of joint application of Herbaleonuri injection and oxytocin in preventing postpartum bleeding in cesarean section. Methods：randomly divide 200 cases of cesarean section into two groups： experimental group and control group （100 cases for each group）. Experimental Group： inject 2ml （40mg） Herbaleonuri into uterine wall and 2ml （ 40mg ） on the upper edge of incision after new - born baby＇s umbilical cord is cut with vessel forceps,and at the same time inject 20IU oxytocin by intravenous drop; apply 2ml （40mg） Herbaleonuri injection to muscle two hours after surgery, and thereafter repeat this step every 12hours with 2ml（40mg）each time for 3 -5days in a row. Control Group：apply 20 IU oxytocin by regular intravenous drop. Resuits： （1）observe results five minutes after Herbaleonuri injection is applied in cesarean section. Experimental Group：95 eases experienced obvious uterine contraction, and incision bleeding was greatly reduced, and the clearly effective rate was 95% ; other 5 cases experienced normal contraction, and bleeding was eased, and the effective rate was 5% ; none of the 100 cases had bad contraction or heavy bleeding, and ineffective rate was 0% ;Control Group： clearly effective rate, effective rate and ineffective rate were 88% ,5% and 7% respectively; obvious difference existed between two groups（P〈0. 05）. Not a single case in the treatment group needs supplement of therapeutic uterine contraction agent or taking of other injury surgery control measures or blood transfusion; in the experimental group,7 cases need injection of therapeutic -dose uterine contraction agent, 2 cases applied B - lynch suture, and 2 cases needed blood transfusion. （2）observation results of bleeding 24hrs after cesarean section：90 cases in the treatment group experienced little bleeding, and the clearly effective rate was 90% ;while other 10 cases in this group were in normal bleeding state,and the effective rate was 10% ;no case in this group experienced severe bleeding,and total effective rate was 100%. In the control group,83 cases experienced little bleeding, and effect was obvious, and the clearly effective rate was 83% ;other 15 cases in this group were in normal bleeding state, and effective rate was 15%;only the rest 2 cases had bad bleeding situation （ 2% ） ; total effective rate of this group was 98%. （3）HCT change 48hours before and after birth：by measuring HCT value of 200 eases before and after surgery, average HCT value of the treatment group before and after surgery was 34. 29 and 31.2 respectively, with difference value 3.09; in the control group ： average HCT value before and after surgery was 34.34 and 31. 16 respectively, With difference value 2. 98; no obvious difference exists in two groups. Discussion： joint application of Herbaleonuri injection and oxytocin has obvious effect in preventing postpartum bleeding in cesarean section is obvious, and can effectively prevent occurrence of postpartum bleeding. Results showed that negative influence on mother and baby can be minimized by not adding therapeutic uterine contraction agent and by not applying other injury therapy. Though HCT value of two groups was not in great dispute by taking other curative measures, such measure can minimize negative impact on pregnant women.