米索前列醇应用于疤痕子宫剖宫产术中促进子宫收缩的效果观察

Observation on the effects of misoprostol to promote uterine contraction in the scar uterus cesarean section

目的观察米索前列醇应用与疤痕子宫剖宫产术中对子宫收缩的促进作用。方法选取2010年5月至2011年10月期间在我院需行剖宫产的有疤痕子宫的84例产妇，随机分为观察组及对照组各42例，对照组在胎儿娩出后静脉滴注缩宫素20u，子宫体肌注20U，观察组在对照组用药基础上加用米索前列醇400磺，直肠用药，观察两组术中及术后出血量、用药不良反应。结果观察组术中及术后出血量分别为（228．73±30．94）ml、（110．32±45．71）ml，对照组分别为（294．88±50．42）ml、（160．29±60．84）ml，观察组术中及术后2h出血量均明显少于对照组，比较差异有显著性垆〈0．05）;观察组药物不良反应发生率9．52％，对照组0，比较差异无显著性（P〉0．05）。结论米索前列醇直肠放药，对于疤痕子宫剖宫产的产妇促进子宫收缩作用较单一使用缩宫素效果好，并且用药安全、简单，值得临床推广。

Objective To observe the effect of misoprostol to promote uterine contraction in scar uterus cesarean section. Methods 84 cases of puerpera with scar uterus needing cesarean section in our hospital from May 2010 to October 2011 were selected. All patients were randomly divided into two groups. The control group had 42 cases which applied intravenous drip 20 U of oxytocin after the expulsion of fetus, and uterine body intramuscular injection 20 U. The observation group had 42 cases which applied misoprosto1400 μg used in rectum on the basis of control group. The blood loss during and after the operation and adverse drug reaction were observed. Results The blood loss of the observation group during and after the operation were （228.73 ±30.94） ml, （110.32± 45.71 ） ml, and （294.88 ± 50.42 ） ml, （ 160.29± 60.84 ） ml in the control group. The blood loss of the observation group during and 2 hours after the operation were obviously less than those of control group. It was significantly different （P〈0.05）. Adverse drug reaction incidence rate of the observation group was 9.52%, and 0 in the control group. There was no statistical significant difference （P〉0.05）. Conclusion Misoprostol using in rectum has better effects than the single use of oxytocin to promote uterine contraction for puerpera of scar uterus cesarean section. And it＇ s safe, simple, deserving clinical application.