麦角新碱联合缩宫素预防瘢痕子宫剖宫产产后出血的疗效

Efficacy of Ergometrine Combined with Oxytocin in Preventing Postpartum Hemorrhage of Cesarean Section of Scarred Uterus

目的探究麦角新碱联合缩宫素预防瘢痕子宫(SU)剖宫产产后出血的临床作用。方法选取2021年1月-2023年5月遂川县妇幼保健院拟行剖宫产分娩的60例SU产妇,经随机数字表法分为对照组(30例)与观察组(30例),对照组给予缩宫素处理,观察组则采用麦角新碱联合缩宫素处理,比较两组PPH预防效果、出血量(术后12、24 h)、输血率、血红蛋白(Hb)、产后恢复情况(术后住院时间、子宫底下降速度)、不良反应发生率。结果观察组产后出血预防有效率高于对照组(P<0.05);观察组术后12、24 h出血量均少于对照组,且输血率小于对照组(P<0.05);两组术后24 h的Hb水平均低于术前(P<0.05),但组间比较,差异无统计学意义(P>0.05),而观察组Hb下降值小于对照组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05);观察组术后住院时间短于对照组,且子宫底下降速度大于对照组(P<0.05)。结论麦角新碱联合缩宫素对SU剖宫产产后出血具有良好预防作用,可降低产妇产后出血量,减少其血红蛋白流失,加速产后恢复,且具有较高用药安全性。

Objective To explore the clinical effect of ergometrine combined with oxytocin in preventing postpartum hemorrhage of scarred uterus(SU)after cesarean section.Methods From January 2021 to May 2023,60 SU parturients undergoing cesarean section in Suichuan County Maternal and Child Health Hospital were selected and divided into control group(30 parturients)and observation group(30 parturients)by random number table method.The control group was treated with oxytocin,while the observation group was treated with ergometrine combined with oxytocin.The preventive effect of PPH,postpartum hemorrhage(12 h and 24 h after operation),blood transfusion rate,hemoglobin(Hb),postpartum recovery(postoperative hospitalization time,uterine fundus decline rate)and incidence of adverse reactions were compared between the two groups.Results The effective rate of postpartum hemorrhage prevention in the observation group was higher than that in the control group(P<0.05).The amount of bleeding at 12 and 24 h after operation in the observation group was less than that in the control group,and the blood transfusion rate was less than that in the control group(P<0.05).The Hb level of the two groups at 24 h after operation was lower than that before operation(P<0.05),but there was no significant difference between the two groups(P>0.05),while the decrease of Hb in the observation group was less than that in the control group(P<0.05).The postoperative hospitalization time of the observation group was shorter than that of the control group,and the decline rate of the uterine fundus was greater than that of the control group(P<0.05).Conclusion Ergometrine combined with oxytocin has a good preventive effect on postpartum hemorrhage of SU cesarean section,which can reduce the amount of postpartum hemorrhage,reduce the loss of hemoglobin,accelerate postpartum recovery,and has high drug safety.