马来酸麦角新碱联合米索前列醇治疗剖宫产产后出血的临床研究

Clinical study on ergometrine maleate combined with misoprostol in treatment of postpartum hemorrhage after cesarean section

目的探讨马来酸麦角新碱注射液联合米索前列醇片治疗剖宫产产后出血的临床疗效。方法选取2017年1月—2019年4月绵阳市中心医院妇产科收治的剖宫产术中发生出血100例患者作为研究对象,根据产妇实际用药情况分为对照组和治疗组,每组各50例。对照组术后将米索前列醇片0.2 mg放置于产妇直肠内。治疗组在对照组基础上肌肉注射马来酸麦角新碱注射液0.2 mg。观察两组的临床疗效,比较两组的临床指标、血清生化指标。结果治疗后,对照组和治疗组的总有效率分别为80.00%、94.00%,两组比较差异有统计学意义(P<0.05)。治疗后,治疗组产后2 h出血、产后2~24 h出血、产后恶露持续时间、住院时间明显低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组血清一氧化氮(NO)、一氧化氮合酶(NOS)平均显著降低,同组治疗前后比较差异有统计学意义(P<0.05);并且治疗后,治疗组血清NO、NOS水平明显低于对照组,两组比较差异具有统计学意义(P<0.05)。结论马来酸麦角新碱注射液联合米索前列醇片治疗剖宫产产后出血具有较好的临床疗效,能减少产后出血量,改善NO、NOS水平,具有一定的临床推广应用价值。

Objective To investigate the efficacy of Ergometrine Maleate Injection combined with Misoprostol Tablets in treatment of postpartum hemorrhage after cesarean section.Methods Patients(100 cases)with postpartum hemorrhage after cesarean section in Mianyang Central Hospital from January 2017 to April 2019 were enrolled in this study.According to the difference treatment plan,patients were randomly divided into control and treatment groups,and each group had 50 cases.Patients in the control group were given Misoprostol Tablets,and 0.2 mg was placed in the rectum.Patients in the treatment group were im administered with Ergometrine Maleate Injection 0.2 mg on the basis of the control group.After treatment,the clinical efficacies were evaluated,and clinical indicators,and serum biochemical indexes in two groups were compared.Results After treatment,the clinical efficacies in the control and treatment groups were 80.00%and 94.00%,respectively,and there was difference between two groups(P<0.05).After treatment,postpartum hemorrhage within 2 h,postpartum hemorrhage within 2—24 h,postpartum lochia duration,and hospital stay in the treatment group were significantly lower than those in the control group,and there was difference between two groups(P<0.05).After treatment,the levels of NO and NOS in two groups were significantly decreased,and the difference was statistically significant in the same group(P<0.05).And the levels of NO and NOS in the treatment group were significantly lower than those in the control group,with significant difference between two groups(P<0.05).Conclusion Ergometrine Maleate Injection combined with Misoprostol Tablets has clinical curative effect in treatment of postpartum hemorrhage after cesarean section,can reduce the amount of postpartum hemorrhage,and improve the levels of NO and NOS,which has a certain clinical application value.