益母草联合缩宫素促进剖宫产子宫复旧、预防产后出血的效果及产后出血影响因素分析

Clinical Value of Motherwort Combined with Oxytocin in Promoting Uterine Involution and Preventing Postpartum Hemorrhage and Factors Affecting Postpartum Hemorrhage in Cesarean Section

目的分析益母草联合缩宫素促进剖宫产子宫复旧、预防产后出血的效果及产后出血的影响因素。方法选取我院2016年3月—2018年4月收治的126例剖宫产产妇,根据术后用药不同分为观察组与对照组各63例,对照组给予缩宫素治疗,观察组在对照组基础上联合益母草注射液治疗。比较两组产后2、12、24h出血情况,术后第1、3、5日子宫复旧情况;再根据是否有产后出血分组,并采用单因素分析和多因素logistic回归分析探讨剖宫产产后出血的影响因素。结果两组随术后时间的延长,出血量均呈下降趋势(P<0.05或P<0.01),观察组术后2、12、24h出血量均明显少于对照组(P<0.05或P<0.01)。两组随术后时间的延长,子宫高度均呈下降趋势(P<0.05或P<0.01),观察组术后3d、5d子宫高度明显低于对照组同时间(P<0.01)。126例剖宫产患者中38例(30.16%)出现产后出血,88例(69.84%)未出现产后出血,有流产史、合并妊娠期高血压、合并妊娠期糖尿病、单用缩宫素是剖宫产产后出血的独立危险因素。结论益母草联合缩宫素可有效促进子宫复旧及减少产后出血,有流产史、合并妊娠期高血压、合并妊娠期糖尿病者剖宫产产后出血的风险较大。

ObjectiveTo analyze the clinical value of motherwort combined with oxytocin in promoting uterine involution and preventing postpartum hemorrhage and factors affecting postpartum hemorrhage in cesarean section.MethodsThe clinical data of 126 cases of cesarean section from March 2016 to April 2018 were collected and divided into control group ( n =63) and observation group ( n =63) according to different medications after surgery.The control group was treated with oxytocin, and the observation group was treated with motherwort injection on the basis of control group.Postpartum hemorrhage at 2, 12, and 24 h after childbirth was compared between the two groups, and uterine involution on the 1 st , 3 rd , and 5 th day postoperatively were compared.They were sudivided according to presence of postpartum hemorrhage.The influencing factors for postpartum hemorrhage after cesarean section were analyzed by univariate analysis and multivariate logistic regression.ResultsThe bleeding volume was decreased with time after operation ( P <0.05 or P <0.01), which was significantly smaller at 2, 12, and 24 h after operation in the observation group than in the control group ( P <0.05 or P <0.01).The uterine height of the two groups was decreased with the prolongation of time after operation ( P <0.05 or P <0.01).The uterine height of the observation group was significantly lower than that of the control group on the 3rd and 5th days after operation ( P <0.01).Of 126 cases of cesarean section, 38 cases (30.15%) had postpartum hemorrhage, and 88 cases (69.84%) had no postpartum hemorrhage.Abortion history, gestational hypertension, gestational diabetes mellitus and oxytocin alone were independent risk factors for postpartum hemorrhage after cesarean section.ConclusionMotherwort combined with oxytocin can effectively promote uterine involution and reduce postpartum hemorrhage.The risk of postpartum hemorrhage after cesarean section is higher in patients with abortion history, gestational hypertension and gestational diabetes mellitus.