剖宫产术中缩宫素应用的临床观察

Clinical observation on application of Oxytocin in cesarean section

目的观察缩宫素在剖宫产术中不同的给药方式对血流动力学的影响。方法选择本院2010年5月～2011年5月40例足月子宫下段剖宫产孕妇,随机分为两组,其中一组20例为观察组,于胎儿娩出后子宫肌注缩宫素10U,同时由另一通道静脉泵注以>10min静脉匀速输注0.9%氯化钠溶液50mL及10IU缩宫素;另一组20例为对照组,于胎儿娩出后子宫肌注缩宫素l0U,同时55～60s内静脉单次推注0.9%氯化钠溶液10mL及10IU缩宫素。常规监测BP、SpO2和ECG。结果两组患者用药后5min血压、心率升高,用药后10min,血压、心率向正常水平靠拢,其中血压升高幅度对照组显著高于观察组,差异有高度统计学意义(P<0.01),心率升高幅度对照组高于观察组,差异有统计学意义(P<0.05),不良反应发生率对照组明显高于观察组,差异有高度统计学意义(P<0.01);两组产妇用药后子宫收缩情况以单盲法询问手术医生,两组产妇在用药后5、10、15、20min子宫紧张度,差异无统计学意义(P>0.05)。结论同剂量的缩宫素静脉泵注,药物浓度相对较低,可起到收缩子宫的作用,同时又能预防和减轻心血管不良反应的发生,保证手术的安全性。

Objective To observe the effect of Oxytocin in cesarean section delivery with a different way to hemodynamics. Methods Forty pregnant women with lower uterine segment cesarean section from May 2010 to May 2011 in our hospital were randomly divided into two groups, 20 patients were in the observation group, the uteruses were given 10 U Oxytocin with intramuscular injection after the baby were delivered, while they were given 0.9% saline solution of 50 mL and 10 IU Oxytocin by the other channel of amedrop with speech of more than 10 min; 20 patients in control group, who were given 10 U Oxytocin in the uterus after the baby been delivered with intramuscular injection, while they were given 10 mL 0.9% saline solution and 10 IU Oxytocin with intravenous single injection of 55-60 s. BP, SpO2 and ECG were detected. Results Blood pressure and the heart rate of two groups increased after 5 min treatment, blood pressure and the heart rate of two groups were increased and closed to the normal levels after 10 min treatment, the increase of blood pressure in control group were significantly higher than that of observation group, difference was highly significant （P 0.01）, the increase of heart rate in control group were higher than that of observation group, difference was significant （P 0.05）, adverse reaction rates of control group were markedly higher than that of observation group, difference was highly significant （P 0.01）. Uterine contractions of two groups after treatment in 5, 10, 15, 20 min, there was no significant difference in uterine tensity between two groups （P 0.05）. Conclusion The same dose of Oxytocin is given by amedrop, drug concentration is relatively low, it not only can play a role in contraction of the uterus, but also can prevent and reduce the incidence of cardiovascular adverse reactions in order to ensure the safety of operation.