不同剂量马来酸麦角新碱预防宫缩乏力性产后出血的安全性和有效性临床研究

A Clinical Research of the Safety and Effectiveness of Different Doses of Ergometrine Maleate for the Prevention of Postpartum Hemorrhage

目的:探讨阴道分娩后出现宫缩乏力的患者,应用不同剂量马来酸麦角新碱注射液的安全性和有效性。方法:选取2018年11月至2019年6月在广州市妇女儿童医疗中心住院、阴道分娩产后出现宫缩乏力的患者64例,随机分为马来酸麦角新碱单支组和马来酸麦角新碱双支组各32例,观察两组患者产后2小时和24小时阴道出血量、特殊干预情况、用药前和用药后半小时及2小时的血压和心率、不良反应发生情况等。结果:产后2小时阴道出血量,单支组明显多于双支组[(419.80量,单支组反应)ml vs.(350.94量,单支组反应)ml,P<0.05]。产后24小时阴道出血量单支组明显多于双支组[(496.02组意义支组反应)ml vs.(428.59组意义支组反应)ml,P<0.05]。两组组内用药前和用药后收缩压、舒张压、心率比较,差异有统计学意义(P<0.05),双支组发生不良反应3例,单支组未发现不良反应。结论:马来酸麦角新碱注射液用于预防宫缩乏力性产后出血,双支剂量较单支剂量效果显著,但用药后可影响血压和心率,需严密监测患者生命体征。

Objective:To investigate the safety and effectiveness of different doses of ergometrine maleate injection for the prevention of postpartum hemorrhage following labor and delivery with uterine atony. Methods:64 patients who were hospitalized in Guangzhou Women and Children′ s medical center and experienced uterine atony after vaginal delivery from November 2018 to June 2019 were randomly divided into two groups. They were the single dose group and the double dose group of ergometrine maleate injection. Each group had 32 cases. Data on the amount of vaginal blood loss at 2 hours and 24 hours post-delivery,special interventions,variation of blood pressure and heart beat before administration and at half an hour and 2 hours after administration,and adverse effect were collected. Results:The amount of total blood loss at 2 hours after delivery in the single dose group was significantly more than that of had the double dose group[(419.80 ble dose)ml vs.(350.94 ble dose)ml,P<0.05]. The amount of total blood loss at 24 hours after delivery in the single dose group was significantly more than that of had the double dose group[(496.02 double)ml vs.(428.59 ble dose)ml,P<0.05]. There were significant differences in the variations of systolic,diastolic blood pressure and heart rate within group(P<0.05). 3 cases from double dose group experienced adverse reactions comparing nobody occurred in single dose group. Conclusion:To prevent postpartum hemorrhage due to uterine atony,double dose of ergometrine maleate injection has more remarkable effect than single dose,but it needs close monitoring vital signs of patients because the blood pressure and heart rate could be affected after administration.