欣母沛与米索前列醇预防前置胎盘产后出血对比研究.docVIP

欣母沛与米索前列醇预防前置胎盘产后出血对比研究 　　 　　 【摘要】 目的 比较欣母沛与米索前列醇预防前置胎盘产后出血的临床疗效。方法 选择存在产后出血高危因素并有剖宫产指征的前置胎盘孕妇60 例，随机分为观察组和对照组各30例，对照组于剖宫产术中胎儿娩出后即在子宫体部注射缩宫素2 U及口服米索前列醇0?4 mg,观察组给予宫壁注射欣母沛250 μg，两组均予20 U缩宫素静脉维持。比较两组产后2 h内及24 h内的出血量。结果 观察组产后2 h内及24 h内的出血量较对照组明显减少，差异有统计学意义(P 0?05)。结论 应用欣母沛预防前置胎盘产后出血比米索前列醇效果更显著。 　　 【关键词】 欣母沛；米索前列醇；前置胎盘；产后出血Contrast study on preventing hemorrhage after cesarean section in placenta previa by using hemabate and misoprostol. WANG Hui, YANG Shu?gang, LI Chun?hong, et al.Department of Maternity,The people?s Hospital of Zhucheng,Shandong 262200,China. 　　 【Abstract】 Objective To compare the clinical efficacy of hemabate and misoprostol for preventing hemorrhage after cesarean section of women with placenta previa?Methods 60 patients of cesarean section with placenta previa were assigned to two groups: observation group and control group? Control group was injected oxytocin into their uterine corpus immediately after cesarean section and oral misoprostol 0?4 mg,observation group was injected hemabate,then the two groups all were injected oxytocin by intravenous drip simultaneously? The bleeding amounts of 2 hours and 24 hours after operation were compared?Results The bleeding amounts of 2 hours and 24 hours in observation group were lower than that of the control group (P0?05)?Conclusion Hemabate is more effective than misoprostol for preventing hemorrhage after cesarean section of women with placenta previa. 　　 【Key words】 Hemabate;Misoprostol;Placenta previa;Hemorrhage after cesarean section 我国孕产妇死亡的首要原因是产后出血，其中由宫缩乏力引起的产后出血达70%～80%［1］。前置胎盘是妊娠晚期出血常见的原因，尤其是引起产前产后难以控制的大出血时将严重危及母儿的生命［2，3］。在防治前置胎盘产后出血时，临床采取的措施包括使用缩宫素、卡孕栓等常规宫缩剂，结扎子宫动脉，宫腔填塞及介入栓塞等措施，甚至被迫行子宫切除术，给患者带来永久性和不可逆的伤害。本研究通过比较欣母沛与米索前列醇预防前置胎盘产后出血的临床疗效，探讨欣母沛防治前置胎盘产后出血的临床价值。现报告如下。1 资料与方法1?1 一般资料 选取我院2009年1月至2011年10月收治的存在产后出血高危因素并有剖宫产指征的前置胎盘孕妇60例为研究对象，均为单胎头位妊娠。随机分为观察组和对照组各30例，其中观察组年龄22～40岁，平均31?6岁，中央性前置胎盘10例，部分性前置胎盘14例，边缘性前置胎盘6例；对照组年龄21～39岁，平均30?5岁，中央性前置胎盘9 例，部分性前置胎盘16例，边缘性前置胎盘5例。排除标准：有前列腺素药物使用的禁忌证，病史不清楚、诊断不明