欣母沛配合手法干预预防剖宫产产后出血的观察

Observation on Hemabate Combined with Manual Technique for Prevention and Reduction of Hemorrhage after Cesarean Section

目的：观察欣母沛配合手法干预在预防和减少剖宫产术后出血的疗效。方法：前瞻性观察我院住院有产科剖宫产指征，并存在产后出血高危因素的产妇200例，随机分为4组，所有产妇均于胎儿娩出后静脉推注生理盐水20ml加缩宫素20U。A组：对照组（50例），不作其他处理；B组：欣母沛组（49例），于胎儿娩出后立即于子宫体部注射250μg欣母沛；C组：手法干预组（51例），在胎儿娩出后，胎儿娩出后手法持续宫底按摩，并适度牵拉脐带；D组：欣母沛加手法干预组（50例）。准确测量术中出血量和产后2小时及24小时出血量，记录胎盘娩出时间和手术时间。结果：以欣母沛加手法干预组（D组）的术中出血量、产后2小时出血量及产后出血发生率最低，B组、C组、A组依次升高；以欣母沛加手法干预组（D组）的胎儿娩出至胎盘娩出时间和总手术时间最短，C组、B组、A组依次延长，其差异均有统计学意义。结论：胎儿娩出后采用欣母沛配合手法按摩子宫，效果明显好于其他处理方法，并具有方便、快速、安全的特点。

Objective：To assess the effect of hemabate combined with manual technique in prevention and reduction of hemorrhage after cesarean section （CS）. Methods： This prospective study was performed in 200 pregnant women of the hospital. 200 cases were randomly assigned into four groups. 20U oxytocin was injected intravenously in all groups after delivery of the fetus. Group A （n=50）：no other treatment. Group B （n=49）： 250μg Hemabate was injected into the uterine corpus immediately after the fetus delivered. Group C （n=51）： The manual technique of continued kneading uterine bottom and gently pulling the cord was applied. Group D （n=50）： Hemabate and manual technique were combined and applied. The amount of blood loss within 2 hours and 24 hours were measured precisely, the time of the operation were also noted precisely. Results： The bleeding amounts during the operation and at two hours after delivery and the occurrences of postpartum hemorrhage in Group D were the lest, and Group B, C, and A followed in turn .The time between delivery of the fetus and the placenta and the total time of the operation in Group D were the lest, and Group C, B,and A followed in turn. Conclusions：Hemabate combined with manual technique is convenient, safe, and effective in reduction and prevention of CS postoperative hemorrhage.