益母草注射液联合缩宫素预防剖宫产产后出血的临床疗效及安全性分析

Curative effects and clinical safety of leonurus injection combined with oxytocin in prevention of postpartum hemorrhage after secarean section

目的:观察益母草注射液联合缩宫素预防剖宫产产后出血的临床疗效及安全性分析。方法:选取2013年6月~2014年6月本院进行剖宫产的产妇160例,将其按照随机数字法随机分为观察组和对照组各80例。观察组剖宫产术中胎儿娩出,血管钳钳夹脐带后,立即于切口上方子宫肌壁内注射益母草注射液2ml,并静脉滴注缩宫素20U,术后4h、16h给予益母草注射液肌内注射2ml,每12h 1次持续3d。对照组胎儿娩出后,立即于切口上方子宫肌壁内注射缩宫素20U,并常规给予静脉滴注缩宫素20U,术后4h肌注缩宫素10U,以后每12h注射1次,持续3d。观察两组产后出血率,术中和术后2h、24h出血量,术前到术后24h血红蛋白变化幅度及不良反应发生情况。结果:观察组77例切口出血量显著减少,显效率96.3%,无一例需要其它干预及输血治疗者。对照组出血量显著减少者70例,显效率87.5%。采用其它手段干预6例,输血治疗2例,背带式缝合1例,两组显效率比较差异具有统计学意义(X^2=4.103,P<0.05)。观察组术中出血量、术后2h及24h出血量均低于对照组(t=7.116、6.878、8.853,P<0.05);产妇术前到术后24h Hb变化幅度(16.55±5.78g/L)低于对照组(27.80±6.26g/L)(t=11.810,P<0.05);子宫复旧情况优于对照组(t=13.403、14.425,P<0.05)。两组不良反应主要是恶心、呕吐,颜面潮红,血压升高,轻度胸部不适,观察组不良反应发生率低于对照组(X^2=3.608,P<0.05)。结论:缩宫素联合益母草注射液预防剖宫产产后出血临床疗效好、安全性高,且还可促进子宫复旧,值得临床推广应用。

Objective： To observe and study curative effects and clinical safety of using leonurus injection combined with oxytocin in prevention of postpartum hemorrhage after secarean section. Methods.. From June 2013 to June 2014 in our hospital 160 pregnant women experincing cesarean section were recruited and randomly divided into the observation group and the control group （80 cases in each group）. Women in the observation group were given uterine muscle injec- tion of 2 ml ｜eonurus injection and intravenous drip of 20 U oxytocin immediately after cesarean section. And 2 ml of [e- onurus injection were given 4 h, 16 h after surgery and once a day, lasting for 3 to 5 days. Women in the control group were given 20 U-oxytocin and intravenous drip of 20 U oxytocin after cesarean section, and 20 U oxytocin injection 2 h after surgery, followed by 10 U oxytocin injection every 12 h. The postpartum hemorrhage rate, and 2 h, 24 h of intra- operative and postoperative amount of blood loss, and the change of hemoglobin level and the incidence of adverse reac- tions of two groups were observed and compared. Results： In the observation group, the amount of incision bleeding in 77 （96.3%） women significantly reduced, and no patients needed other intervention and blood transfusion therapy. While in the control group, the amount of incision bleeding in 70 （87.5%） women significantly reduced, and 6 patients needed other intervention and blood transfusion therapy （n= 2）. The effective rate of two groups had a significant difference （Xz = 4. 103, P^0.05）. Intraoperative blood loss, 2 h and 24 h postoperative blood loss in the observation group were significant lower than those in the control group （t = 7.116, 6.878, 8.853, P〈0.05）. Hemoglobin variations 24 h after surgery in the observation group was （16.55 ± 5.78） g/L, which was significantly lower than that in the control group F（27.80±6.26） g/L, t= 11.810, P〈0.051. Uterine instauration in the observation group was obviously better than that in the control group （t = 13.403, 14.425, P〈0.05）. Adverse reactions in two groups were mainly nausea, vomiting, facial blushing, high blood pressure and mild chest discomfort, and the incidence of the observation group was significantly lower than that in the control group （X2 = 3.608, P〈 0.05）. Conclusions： Oxytocin combined with leonurus inj6ction has better clinical curative effects and higher safety in preventing postpartum hemorrhage after cesarean delivery, which could also promote uterine instauration and would be worthy of clinical popularization and application.