麦角新碱联合缩宫素降低第二产程剖宫产手术出血的效果

Observation on the Therapeutic Effect of Ergonovine Combined with Oxytocin to Reduce Cesarean Section Hemorrhage in the Second Stage of Labor

目的:分析在第二产程剖宫产术中使用麦角新碱联合缩宫素对降低术中及术后发生产后出血的效果及不良反应发生情况。方法:对2019年1月—2023年3月于新疆生产建设兵团第一师医院产科分娩、在第二产程行急诊子宫下段剖宫产手术的86例产妇临床资料进行回顾性研究,根据药物使用不同分为对照组与观察组。比较第二产程剖宫产术中、产后发生出血的原因,剖宫产手术中与术后24 h的出血量,两组手术时间、术后24 h血红蛋白下降数值,用药后不良反应发生情况。结果:第二产程剖宫产术中发生产后出血原因统计,子宫收缩乏力为主要原因,占比75.58%。观察组剖宫产术中出血量与24 h的出血量均低于对照组,差异有统计学意义(P<0.05)。观察组的手术时间、术后24 h血红蛋白指标均优于对照组,差异有统计学意义(P<0.05)。观察组共出现头晕、头痛2例,恶心、呕吐2例,胸痛、心悸1例,血压升高1例,不良反应发生率为10.71.%,与对照组比较,差异无统计学意义(P>0.05)。结论:麦角新碱联合缩宫素在第二产程剖宫产术中预防性使用,可以减少剖宫产术后出血发生率,能够有效地降低产后出血量,缩短手术时间,且不良反应无明显增加,可考虑在产科预防第二产程剖宫产术中出血应用并予以推广。

Objective:to analyze the therapeutic effect of administering ergonovine combined with oxytocin in second stage cesarean section on reducing intraoperative and postoperative postpartum hemorrhage and the occurrence of adverse reactions.Methods:a retrospective study was conducted on the clinical data of 86 cases of women who were delivered in the Department of Obstetrics of the First Division Hospital of Xinjiang Production and Construction Corps and underwent emergency lower uterine segment cesarean section in the second stage of labor from January 2019 to March 2023,and they were divided into the control group and the observation group according to the different administration of drugs.We compared the causes of intraoperative and postpartum hemorrhage during cesarean section in the second stage of labor,the amount of hemorrhage during cesarean section operation and 24 hours after operation,the operation duration,the level of hemoglobin 24 hours after operation,and the incidence of adverse reactions after medication in the two groups.Results:Statistics on the causes of postpartum hemorrhage during cesarean section in the second stage of labor showed that,weak uterine contraction contributed to the main cause,accounting for 75.58%.The intraoperative hemorrhage and hemorrhage 24 hours after cesarean in the observation group were lower than those in the control group,and the difference was not statistically significant(P<0.05).The operation duration and hemoglobin indexes 24 hours after the cesarean of the observation group were better than those of the control group,and the difference was statistically significant(P<0.05).In the observation group,there were 2 cases of dizziness and headache,2 cases of nausea and vomiting,1 case of chest pain and palpitation,and 1 case of elevated blood pressure,and the incidence rate of adverse reactions was 10.71.%,which was not statistically significant when compared with that of the control group(P>0.05).Conclusion:The prophylactic application of ergonovine combined with uterotonin in second stage cesarean section can reduce the incidence of post-caesarean hemorrhage,can effectively reduce the amount of postpartum hemorrhage,shorten the duration of the operation,and there is no significant increase in the adverse reactions,and it can be considered for the prevention of second stage cesarean section hemorrhage in obstetrics.