麦角新碱不同用法和用量对剖宫产术中子宫收缩效果的临床观察

Clinical observation of different usage and dosage of ergometrine in contractile effect of uterus during cesarean section

目的观察剖宫产术中麦角新碱不同用法和用量对子宫收缩效果的影响。方法 2017年1月-2019年5月于抚州市东乡区第二人民医院收治的剖宫产产妇120例,以简单随机化法分为3组(A、B、C组,n=40),术中均实施麦角新碱干预。A组给予麦角新碱0.2 mg肌肉注射,B组给予麦角新碱0.2 mg+25%葡萄糖注射液200ml静脉滴注,C组麦角新碱以静脉滴注与肌肉注射联合的方式干预,即胎儿娩出后,静脉注射麦角新碱0. 1 mg,之后将麦角新碱0.1 mg+25%葡萄糖注射液200 ml静脉滴注,比较3组产妇干预结果的差异性。结果 A组胎盘剥离时间、术中出血量、产后2 h和24 h出血量、术前术后血红蛋白差值均高于B组和C组,B组胎盘剥离时间、术中出血量、产后2 h和24 h出血量、术前术后血红蛋白差值均高于C组(P <0. 05);3组干预后血压、心率值及不良反应发生率比较差异无统计学意义(P>0. 05)。结论麦角新碱以静脉滴注与静脉注射联合方式应用于剖宫产产妇中,能够更好控制其出血量,促进胎盘剥离。

Objective To observe the effects of different usage and dosage of ergometrine on uterine contraction during cesarean section. Methods 120 cases of cesarean section were divided into three groups(A,B,C,n = 40) by simple randomization method,in the Secend Pople’s Hospital of Dongxiang District,from January 2017 to May 2019,and ergometrine intervention was performed during the operation. Group A was given intramuscular injection of ergometrine 0. 2 mg,group B was given intravenous infusion of ergometrine 0. 2 mg + 25% glucose injection 200 ml,and ergonovine group C in the form of intravenous drip with intramuscular intervention,namely the fetal childbirth,after intravenous injection of ergonovine 0. 1 mg.After delivery,ergometrine 0. 1 mg + 25% glucose injection 200 ml was infused intravenously to compare the differences in maternal intervention results between the three groups. Results The placental dissection time,intraoperative blood loss,2 h and 24 h postpartum hemorrhage,and preoperative and postoperative hemoglobin differences were higher in group A than in groups B and C. Group B placental dissection time,intraoperative blood loss,2 h and 24 h postpartum hemorrhage bleeding volume,preoperative and postoperative hemoglobin differences were higher than those in group C(P < 0. 05). There was no significant difference in blood pressure,heart rate and incidence of adverse reactions between the three groups after intervention(P > 0. 05). Conclusion Ergometrine injection combined with intravenous infusion can better control the blood loss and promote the detachment of placenta.