米索前列醇预防产后出血的临床研究

The Clinial Study of Misoprostol on Preventing Postpartum Hemorrhage

目的研究米索前列醇在预防产后出血中的临床疗效。方法采用随机分组的原则将300例正常单胎足月的自然分娩产妇分成观察组152例和对照组148例。胎儿娩出后,观察组产妇立即口服米索前列醇400μg,对照组产妇立即肌肉注射缩宫素20 u,测定并分析两组产妇产后出血量、血压、产后24 h血红蛋白、红细胞压积、第三产程时间、药物不良反应等指标。结果观察组第三产程时间、产后2 h及24 h出血量显著优于对照组(P<0.05),两组产妇产后24 h血红蛋白、红细胞压体积、血压等方面差异不具有统计学意义(P>0.05)。观察组产妇发生寒战、发热者比例显著高于对照组(P<0.05),但无需特殊处理即恢复正常。药物不良反应未见显著差异(P>0.05)。结论胎儿娩出后即口服米索前列醇促进子宫收缩能力强于肌注缩宫素,可有效缩短第三产程时间,降低产生出血的发生率,且具有用药简单、价格低廉、储存方便、安全性高等优点,值得临床应用推广。

Objective To study misoprostol on preventing postpartum hemorrhage in the clinical efficacy. Methods 300 cases of natural labor puerpera were divided into group（ 152 cases） and control group（ 148 cases） , after delivery of fetus, the observation group maternal oral misoprostol 400 μg, controls for maternal intramuscular oxytocin 20 u,determination and analysis of two groups of postpartum hemorrhage volume, blood pressure, postpartum 24 h hemoglobin, hematocrit, produce cheng time in third, and other indicators. Results Group time of the third stage of labor, bleeding volume in 24 h were significantly better than the control group （P 〈 0.05 ） , two groups of maternal postpartum 24 h hemoglobin, blood pressure, blood pressure, volume differences do not have statistical significance （ P 〉 0.05 ） , the observation group of maternal shiver, fever rate is significantly higher than control group （ P 〈 0.05 ） , adverse drug reaction did not see significant difference （ P 〉 0.05 ）. Conclusion After delivery of fetus, oral misoprostol can effectively shorten the time of the third stage of labor, reduction of the incidence of bleeding.