产后出血高危因素产妇预防性使用马来酸麦角新碱的临床疗效研究

Research on clinical effectiveness of ergometrine maleate on prevetion of postpartum hemorrhage for high-risk pregnant women

目的探讨马来酸麦角新碱注射液预防性使用对高危产妇产后出血的临床疗效和安全性。方法选取2018年6月-12月就诊于株洲市中心医院产后出血高危因素的产妇200例,按照胎儿娩出后和回病房时用药情况不同随机分为两组,对照组为单用缩宫素,观察组为缩宫素联合麦角新碱(分娩后缩宫素+麦角新碱,术后麦角新碱)。比较各组术中及产后2、4、12、24 h出血量,额外产后出血止血措施的使用率及用药后产妇血压的变化情况。结果观察组术中出血量及产后12、24 h出血增量分别为(337.0±148.1)、(75.8±16.8)、(116.4±20.3) mL,明显低于对照组数据(281.6±100.7)、(69.9±17.2)、(107.9±17.2)mL,差异有统计学意义(P<0.05)。比较两组使用其他宫缩剂及止血措施,观察组明显低于对照组,差异具有统计学意义(P<0.05)。结论预防性使用马来酸麦角新碱可明显减少产妇产后出血发生率和出血量,加强子宫收缩安全有效,值得临床推广和应用。

Objective To investigate the clinical efficacy and safety of preventive use of for the postpartum hemorrhage in high-risk pregnant women.Methods 200 patients with high-risk of postpartum hemorrhage in our hospital from June to December 2018 were selected as the research subjects.Patients were divided into two groups according to the different situation of medication after delivery of the fetus and on the way back to the ward.The patients in the control group were treated with oxytocin alone,while in the study group,oxytocin combined with ergometrine was used(oxytocin + ergometrine after childbirth,and ergosine after surgery).The bleeding volume and side effects of the operation,2 h,4 h,12 h,and 24 h after operation were analyzed and compared.Analysis of variance or Chi-square test was used for statistical analysis.Results In the study group,the amount of blood loss of the operation,12 h,and 24 h after operation were(337.0±148.1) mL,(75.8±16.8) mL,(116.4±20.3) mL,respectively,which were significantly less than those in control group(281.6±100.7) mL,(69.9±17.2) mL,(107.9±17.2) mL(The patients in the control group were treated with oxytocin alone,while in the study group,oxytocin combined with ergometrine was used(oxytocin + ergometrine after childbirth,and ergosine after surgery).The bleeding volume and side effects of the operation,2 h,4 h,12 h,and 24 h after operation were analyzed and compared.Analysis of variance or Chi-square test was used for statistical analysis.Results In the study group,the amount of blood loss of the operation,12 h,and 24 h after operation were(337.0±148.1) mL,(75.8±16.8) mL,(116.4±20.3) mL,respectively,which were significantly less than those in control group(281.6±100.7) mL,(69.9±17.2) mL,(107.9±17.2) mL(P<0.05).Compare two groups using other contractions and bleeding,the study group significantly lower than the control group,the difference is statistically significant(P<0.05).Conclusion Preventive use of ergotamine maleate can significantly reduce the incidence and amount of postpartum hemorrhage,strengthen uterine contractions safe and effective,worthy of clinical promotion and application.