缩宫素不同使用方法在重度子痫前期剖宫产术中的应用效果及安全性比较

Comparisons on effects and safety of different applications of oxytocin during caesarean delivery in the patients with severe preeclampsia

目的探讨缩宫素不同使用方法在重度子痫前期剖宫产术中的应用效果及安全性。方法选取2012年3月至2014年5月陕西省人民医院产科收治的124例重度子痫前期患者的临床资料,根据不同治疗方法分为对照组、观察组各62例。对照组采取单纯的宫体注射缩宫素治疗;观察组在对照组基础上给予缩宫素静脉滴注治疗。观察两组患者在术中以及术后的出血情况、住院时间、肛门排气时间、下地活动时间及术中不良反应发生情况。结果观察组患者术中、术后2 h、术后24 h出血量分别为(368±35.7)m L、(112±18.7)m L、(467±50.4)m L,低于对照组[分别为(445±34.5)m L、(174±20.5)m L、(610±75.3)m L](P<0.05);观察组患者术中不良反应发生率(14.5%)低于对照组(46.8%)(P<0.05);对照组与观察组患者的住院时间分别为(7.8±1.35)d、(5.6±0.96)d,肛门排气时间分别为(42.2±4.85)h、(30.4±4.57)h,下床活动时间分别为(31.5±2.68)h、(23.8±2.57)h,两组比较差异有统计学意义(P<0.05)。结论宫体注射缩宫素联合缩宫素静脉滴注可以有效降低重度子痫前期患者剖宫产术中、术后的出血量及不良反应的发生,提高患者的各项临床指标。

Objective To investigate the efficacy and safety of different applications of oxytocin during caesarean delivery in the patients with severe preeclampsia. Methods Clinical data of 124 patients with severe preeclampsia in Shanxi Provincial People＇s Hospital from March 2012 to May 2014 were selected. All cases were divided into study group and control group with 62 patients in each group according to different treatments. The patients in control group were injected oxytocin in corpus alone, The patients in observation group were received intravenous infusion combined with oxytoein injection in corpus. Intra - operative and postoperative bleeding amount, hospital stays, anus exhaust time, activity time and adverse reactions were compared between two groups. Results The bleeding amount of intra -operative, 2 h after and 24 h postoperative in the study group [ （368 ±35.7） mL, （ 112 ± 18.7） mE, （ 467 ± 50. 4 ） mL ] were lower than that in control group [ （445 ± 34. 5 ） mL, （ 174 ± 20. 5 ） mL, （ 610 ± 75.3 ） mL ] （ P 〈 0. 05 ）. The incidence of adverse reactions in the the study group （ 14. 5 % ） was lower than that in control group （46. 8 % ）, （ P 〈 0. 05 ）. The hospital stay in the control group was （7. 8 ± 1.35 ） d and （5. 6 ± 0. 96） d in the study group. The mean anus exhaust time were [ （42. 2 ±4. 85） h and（30. 4 ±4. 57） h respectively]. Postoperative activity out of bed days were（31.5 ±2. 68）b and（23.8±2. 57） h, the differences were statistically significant （P 〈 0. 05 ）. Conclusion Oxytocin intravenous infusion combined with oxytoein injection in corpus can effectively reduced intra - operative or postoperative bleeding amount and incidence of adverse reactions, also improve clinical indexes.