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目的研究米索前列醇不同给药方式联合缩宫素对足月妊娠产妇血钙、纤维蛋白原(FIB)、D-二聚体水平的影响及产后出血的预防。方法选择2012年6月至2014年5月期间我院收治的住院分娩的晚期孕妇180例为研究对象,随机分成A、B、C 3组,每组各60例,A组给予米索前列醇直肠给药联合缩宫素静脉推注,B组给予米索前列醇舌下含服给药联合缩宫素静脉推注,C组只给予单纯缩宫素静脉推注。观察并仔细记录3组产妇血钙、FIB、D-二聚体水平以及产后24 h出血量、记录3组患者的不良反应。结果产妇血钙、FIB、D-二聚体水平A组与B组相比均无明显差异,C组FIB低于A、B组,D-二聚体高于A、B组,差异有统计学意义(P<0.05);3组产妇2 h、24 h出血量,A组与B组相比均无明显差异,C组与A、B组相比出血量较多,两组数据比较差异有统计学意义(P<0.05)。结论米索前列醇联合缩宫素对足月妊娠产妇血钙影响不明显,对FIB、D-二聚体水平影响明显,同时预防产后出血疗效显著,不同给药方式对预防产后出血效果相似。
Objective To study the effects of misoprostol combined with oxytocin on the levels of serum calcium, fibrinogen (FIB) and D-dimer in term pregnant women and the prevention of postpartum hemorrhage. Methods 180 pregnant women admitted to our hospital from June 2012 to May 2014 were enrolled in this study. The patients were randomly divided into A, B and C groups, 60 cases in each group. A group was given misoprostol Rectal administration combined with oxytocin intravenous injection, B group given misoprostol sublingual administration combined with oxytocin intravenous injection, C group only given simple oxytocin intravenous injection. Observe and carefully record the three groups of maternal serum calcium, FIB, D-dimer levels and 24 h postpartum hemorrhage, record the adverse reactions in 3 groups of patients. Results The levels of serum calcium, FIB and D-dimer in maternal group were not significantly different from those in group B, the FIB in group C was lower than that in group A and B, and the level of D-dimer was higher in group A than in group B (P <0.05). The amount of bleeding in 3 maternal groups at 2 h and 24 h was no significant difference between group A and group B. The bleeding volume in group C was significantly higher than that in group A and B, and there was significant difference between the two groups Statistical significance (P <0.05). Conclusion Misoprostol combined with oxytocin has no obvious effect on blood calcium in term pregnant women, and has a significant effect on the levels of FIB and D-dimer. At the same time, the effect of misoprostol in preventing postpartum hemorrhage is significant. The effect of different administration methods on preventing postpartum hemorrhage is similar.