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目的观察剖宫产术中联合应用益母草注射液与缩宫素对产后出血(PPH)的预防作用。方法选取2009年1月至12月于广汉市妇幼保健院进行剖宫产治疗的260例产妇为研究对象,并按照手术顺序随机分为实验组(n=130)和对照组(n=130)。实验组治疗方法为:剖宫产术中,胎儿娩出、血管钳钳夹脐带后,立即给予益母草注射液4mL+静脉滴注缩宫素20IU,术后2h给予益母草注射液肌内注射2mL后,每间隔12h肌内注射一次,2mL/次,持续(3～5)d。对照组仅常规给予静脉滴注缩宫素20IU(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准,得到该委员会批准,分组征得受试对象本人的知情同意,并与之签署临床研究知情同意书)。结果①剖宫产术中益母草注射液注射5min后,实验组显效率、有效率和无效率分别为95.00%,5.00%和0,而对照组分别为88.00%,5.00%和7.00%,两组显效率比较,差异有统计学意义(P<0.05)。②剖宫产后24h出血情况观察,在实验组中,PPH量较少,显效率、有效率及总有效率分别为90.00%,10.00%和100.00%,对照组分别为83.00%,15.00%和98.00%,两组有效率比较,差异无统计学意义(P>0.05)。③实验组分娩前、后48h平均红细胞压积(HCT)及其差值分别为34.29,31.2和3.09;对照组分别为34.34,31.16和2.98,两组比较,差异无统计学意义(P>0.05)。结论本研究结果表明剖宫产术中联合应用益母草注射液+缩宫素作为预防子宫收缩乏力性出血的效果显著,可有效地防治PPH发生,无需补充治疗性宫缩剂或采取其他有损伤性治疗措施。
Objective To observe the preventive effect of combination of Motherwort extract and oxytocin on postpartum hemorrhage (PPH) in cesarean section. Methods 260 maternal women who underwent cesarean section in Guanghan MCH from January to December 2009 were selected as experimental subjects and randomly divided into experimental group (n = 130) and control group (n = 130) . Experimental group treatment: cesarean section, the fetus was delivered, vasoconstrictor clamp umbilical cord immediately after the motherwort injection 4mL + intravenous infusion of oxytocin 20IU, 2h after administration of Motherwort intramuscular injection of 2mL, after each An interval of 12h intramuscular injection, 2mL / time, sustained (3 ~ 5) d. In the control group, only 20IU of intravenous oxytocin was routinely given (the procedure followed in this study was in line with the ethical standards set forth by the Human Body Testing Commission of our hospital, which was approved by the committee and obtained the informed consent of the subject in groups Sign informed consent for clinical study). Results ① In the cesarean section, after 5 minutes of injection of Leonurus extract, the rates of markedly effective, effective and ineffective in the experimental group were 95.00%, 5.00% and 0, respectively, while those in the control group were 88.00%, 5.00% and 7.00% Significant efficiency, the difference was statistically significant (P <0.05). ②24h after cesarean section bleeding observed in the experimental group, PPH less, markedly effective, effective and total effective rate was 90.00%, 10.00% and 100.00%, respectively, the control group were 83.00%, 15.00% and 98.00%. There was no significant difference between the two groups (P> 0.05). (3) The average hematocrit (HCT) and the difference of 48h before and after delivery in the experimental group were 34.29, 31.2 and 3.09, respectively; the control group were 34.34, 31.16 and 2.98 respectively, with no significant difference between the two groups ). Conclusion The results of this study show that the combined application of Leonurus injection and oxytocin in cesarean section is effective in preventing uterine atony bleeding, which can effectively prevent and treat PPH without the need of replenishing therapeutic uterotonics or taking other damage Treatment.