米索前列醇预防剖宫产产后出血的临床疗效观察

Clinical observation of misoprostol in prevention of postpartum hemorrhage after cesarean section

目的:分析米索前列醇预防剖宫产产后出血的临床疗效。方法:选取所在医院妇产科2017年4月至2018年9月收治的81例剖宫产产妇,双盲法纳入分组,对照组(采用常规方法预防产后出血,给予缩宫素,n=40),观察组(在上述基础上加用米索前列醇,n=41),对比两组患者临床效果。结果:观察组产后出血发生率(4.88%)均低于对照组(20.00%);观察组术中、术后2h、术后12h、术后24h出血量均低于对照组(P<0.05);两组术后血红蛋白均发生显著变化,与本组术中相比差异明显(P<0.05);观察组与对照组术后红细胞计数、子宫动脉S/D、阻力指数(RI)与术中相比,无明显变化,组内和组间对比均无明显差异(P>0.05);观察组与对照组不良反应发生率(7.32%vs10.00%)无显著差异(P>0.05)。结论:米索前列醇预防剖宫产产后出血,临床效果明显,能够降低产后出血发生率,减少各个时段出血量,预防效果优于单纯使用缩宫素,用药安全有效。

Objective:To analyze the clinical efficacy of misoprostol in preventing postpartum hemorrhage after cesarean section.Methods:81 cases of cesarean section women in the Department of Obstetrics and Gynecology of our hospital from April 2017 to September 2018 were divided into two groups by double-blind method.The control group(using routine methods to prevent postpartum hemorrhage,giving oxytocin,n=40)and the observation group(using misoprostol,n=41)were compared with the clinical effect of the two groups.Results:The incidence of postpartum hemorrhage in the observation group(4.88%)was lower than that in the control group(20.00%);the amount of bleeding in the observation group was lower than that in the control group(P<0.05);the hemoglobin in the two groups changed significantly after operation(P<0.05);the red blood cell count,uterine artery S/D and resistance index in the observation group and the control group after operation(P<0.05);There was no significant difference in RI between the two groups(P>0.05).There was no significant difference in the incidence of adverse reactions between the observation group and the control group(7.32%VS10.00%)(P>0.05).Conclusion:Misoprostol has obvious clinical effect in preventing postpartum hemorrhage after cesarean section.It can reduce the incidence of postpartum hemorrhage and the amount of bleeding in each period.The preventive effect of misoprostol is better than that of oxytocin alone.It is safe and effective to use misoprostol.