分娩时辅助应用钙剂对高危产妇产后出血量、产程时间及Apgar评分的影响

Effect of intrapartum calcium supplementation on postpartum hemorrhage volume,labor duration,and Apgar score of high-risk pregnant women

目的探讨分娩时钙剂辅助应用对高危产妇产后出血量、产程时间及Apgar评分的影响,为有效减少产后出血量,降低产后出血发生风险,缩短第三产程提供临床依据。方法选取该院2015年6月-2017年6月收治的高危产妇140例,按照随机数字表法分为对照组(70例)和观察组(70例),对照组给予缩宫素+米索前列醇治疗,观察组在此基础上加用葡萄糖酸钙辅助治疗;比较两组产妇产后出血量、产后出血率、第三产程时间、新生儿分娩后1 min Apgar评分及血清Ca^(2+)水平。结果观察组产妇产后2 h和24 h出血量[(190.10±38.05)ml vs.(284.15±56.27)ml、(239.76±47.48)ml vs.(355.30±70.35)ml]均显著少于对照组(均P<0.05),产妇产后出血率(0%vs.7.14%)显著低于对照组(P<0.05),产妇第三产程时间[(6.06±1.10)min vs.(10.48±1.67)min]显著短于对照组(P<0.05);两组新生儿分娩后1 min Apgar[(9.50±0.46)分vs.(9.33±0.41)分]评分比较差异无统计学意义(P>0.05);同时观察组产妇产后血清Ca^(2+)[(2.34±0.25)mol/L vs.(20.3±0.20)mol/L]水平显著高于对照组和产前(P<0.05)。结论分娩时钙剂辅助应用于高危产妇可有效减少产后出血量,降低产后出血发生风险,缩短第三产程,并有助于提高血清Ca^(2+)水平。

Objective To explore the effect of intrapartum calcium supplementation on postpartum hemorrhage volume,labor duration,and Apgar score of high-risk pregnant women,provide a clinical basis for effectively reducing postpartum hemorrhage volume and risk,shortening the third stage of labor. Methods A total of 140 high-risk pregnant women treated in the Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from June 2015 to June 2017 were selected and divided into control group and observation group according to random number table,70 women in each group. The women in control group were treated by oxytocin and misoprostol; the women in observation group were treated by oxytocin,misoprostol,and calcium gluconate. The volumes and incidence rates of postpartum hemorrhage,the time of the third trimester of pregnancy,neonatal one-minute Apgar scores,and serum Ca^2＋ levels in the two groups were compared. Results The volumes of postpartum hemorrhage at 2 and 24 hours after delivery in observation group were（ 190. 10±38. 05） ml and（ 239. 76±47. 48） ml,respectively,which were statistically significantly less than those in control group [（ 284. 15 ± 56. 27） ml and（ 355. 30±70. 35） ml,respectively]（ P〈0. 05）. The incidence rate of postpartum hemorrhage in observation group was 0. 00%,which was statistically significantly lower than that in control group（ 7. 14%）（ P〈0. 05）. The time of the third trimester of pregnancy in observation group was（ 6. 06±1. 10） minutes,which was statistically significantly shorter than that in control group [（ 10. 48±1. 67） minutes]（ P〈0. 05）. Neonatal one-minute Apgar scores in the two groups were（ 9. 50±0. 46） and（ 9. 33±0. 41）,respectively,there was no statistically significant difference between the two groups（ P〉0. 05）. The level of serum Ca^2＋ in observation group was（ 2. 34±0. 25） mol/L,which was statistically significantly higher than that in control group [（ 20. 3±0. 20） mol/L]（ P〈0. 05）. Conclusion Intrapartum calcium supplementation for high-risk pregnant women can efficiently reduce postpartum hemorrhage volume and risk,shorten the third stage of labor,and improve serum Ca^2＋ levels.