宫缩乏力性产后出血18例临床治疗剖析.docVIP

宫缩乏力性产后出血18例临床治疗剖析 　　doi：10.3969/j.issn.1007-614x.2014.21.41 　　摘 要 目的：探讨宫缩乏力性产后出血的治疗效果。方法：2013年1月-12月收治因子宫收缩乏力导致的产后出血18例为观察组，2012年1月-12月收治子宫收缩乏力导致的产后出血患者20例作对照组，进行对比分析。对照组仅给予宫缩素静滴或（和）宫体、肌肉注射。观察组在对照组的基础上在胎儿顺利娩出之后给予12 U的垂体后叶素+0.9%氯化钠注射液 20 ml缓慢静推（约10分钟），同时给予林格氏液500 ml，再给予400 μg的米索前列醇塞肛治疗，两组根据情况给予输血治疗。结果：观察组总有效率100.0%，对照组总有效率95.0%，死亡1例，死亡率5.0%，两组比较差异有统计学意义（P0.05）。结论：宫缩素、垂体后叶素、米索前列醇是预防和控制产后出血的重要药物，疗效显著。 　　关键词 宫缩乏力 产后出血 宫缩素 垂体后叶素 米索前列醇 　　Clinical analysis of 18 cases of postpartum hemorrhage caused by uterine inertia 　　Yang Yulian 　　The Peoples Hospital of Heqing County，Dali State，Yunnan 671500 　　Abstract Objective：To explore the effect of treatment of postpartum hemorrhage caused by uterine inertia.Methods：18 cases with postpartum hemorrhage caused by uterine inertia were selected from January to December 2013 as the observation group.20 cases with postpartum hemorrhage caused by uterine inertia were selected from January to December 2012 as the control group.The control group were treated with oxytocin intravenous drip or（and） the palace body， muscle injection.The observation group were treated with 12 U vasopressin+0.9%NS 20 ml for slow bolus（about 10 minutes） after delivery，at the same time，they were given the ringers solution 500 ml，400 μg misoprostol by anus treatment on the basis of the control group.Two groups were given blood transfusion therapy according to the situation.Results：In the observation group，the total efficiency was 100%.In the control group， the total effective rate was 95%；1 case was death；the mortality was 5%.The difference was statistically significant（P0.05）.Conclusion：Oxytocin，vasopressin，misoprostol are important drug for prevention and control of postpartum hemorrhage.The curative effect is remarkable. 　　Key words Uterine inertia；Postpartum hemorrhage；Oxytocin；Vasopressin；Misoprostol 　　产后出血是产科最为严重的一种并发症，死亡率较高，子宫收缩乏力是导致产后出血的主要原因。为探讨宫缩乏力性产后出血临床特点及治疗效果，2013年1月-12月分娩的产妇2 176例，其中顺产1 561例、剖宫产528例、难产87例，发生产后出血20例，产后出血的发生率0.92%，其中子宫收缩乏力导致的