欣母沛，米索前列醇联合催产素应用预防68例巨大儿产后出血的对比研究.docxVIP

欣母沛，米索前列醇联合催产素应用预防68例巨大儿产后出血的对比研究 吴琼 (上海市闵行区屮心医院妇产科 上海201100) 【摘要】冃的：比较欣母沛与米索前列醇预防巨大儿产后出血的临床疗效。 方法:选择我院2008年1月至2011年12月收治存在产后出血高危因素并有剖宫 产指征的巨大儿孕妇68例，随机分为观察组34例和对照组各34例，对照组于 剖宫产术屮胎儿娩出后即在子宫体部注射缩宫素20单位及口服米索前列醇0.4 mg,观察组给予宫壁注射缩宫素20单位及欣母沛250ug/ml,两组均予20单位 缩宫素静脉维持。比较两组血压变化，产后2h内，24h内的出血量及不良反应 率。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，不良反应率 少，差异有统计学意义(Pt;0.05)o结论:应用欣母沛联合催产素应用预防巨大儿 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；催产素；巨大儿；产后出血 【中图分类号】R714 【文献标识码】A 【文章编号】2095-1752 (2015) 17-0034-03 Contrast study on preventing hemorrhage after cesarean section in 68 cases fetal macrosomia by using hemabate and misoprostol joint oxytocin WuQiong Minhang Central Hospital of Shanghai,201100, China [Abstract] Objective To compare the clinical efficacy of hemabate and misoprostol for preventing hemorrhage after cesarean section of women with fetal macrosomia .Methods 68 patients of cesarean section with fetal macrosomia were assigned to two groups,observation group(34 cases) and control group(34 cases).Control group was injected 20 units of oxytocin into their uterine corpus immediately after cesarean section and Oral 0.4 mg of Misoprostol. Observation group was injected 20 units of oxytocin and 250ug/ml Hemabate,then the two groups were all injected oxytocin by intravenous drip simultaneously.The bleeding amounts of 2 hours and 24 hours after operation were compared.The bleeding amounts of 2 hours and 24 hours in observation group were lower than the control group（Plt;0.05）.C on elusion Hemabate joint oxytoci n is more effective tha n misoprostol for preventing hemorhage after cesarean section of women with fetal macrosomia. 【Key words] Hemabate;Misoprostol;Oxytocin; Fetal macrosomia;Hemorhage 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%⑴。胎儿体重达到或超过4000g者称为巨大儿。随着近年来孕妇营 养过度而致巨大胎儿的孕妇逐年增加。2010年有资料报导我国巨大儿发生率为 7%,—线及二线城市可达12.5%,国外为15.1%[2]。当产力，产道，胎位均正常吋， 常因为胎儿过大导致头盆不称而发生肩难产，产程异常，宫缩乏力，产后出血。 目前救治宫缩乏力引起的产后岀血吋，临床采取的措施包括使用子宫按摩，宫腔 填塞，缩宫素、卡孕栓等常规宫缩剂，输血，子宫Bylinch缝合，结扎子宫动脉，宫 腔填塞及介入栓塞等措施，严重者岀现凝血功能异常: