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目的探讨合谷穴位封闭缩宫素对宫缩乏力性产后出血的预防效果。方法选取安徽省泗县人民医院产科于2013年1月—2013年12月收住的存在产后子宫收缩乏力高危因素的产妇92例,随机分为观察组和对照组各46例,观察组(穴位封闭组)初产妇26例,经产妇20例,年龄19~40岁,孕周37+2~41周,估计胎儿体重2800~4250 g。观察组于胎儿前肩娩出时在产妇左侧或右侧合谷穴位一次性封闭缩宫素10 U;对照组(肌肉注射组)初产妇24例;经产妇22例,年龄20~38岁,孕周37+5~41+2周,估计胎儿体重2900~4200 g。对照组于胎儿前肩娩出时在产妇臀部一次性肌肉注射缩宫素20 U。观察2组产妇产后子宫收缩情况、胎盘剥离时间和产后2 h内阴道出血量及产后出血发生率。结果观察组的子宫收缩情况好(有效率82.6%)、胎盘剥离时间短(3.4±1.6)min、产后2 h阴道出血量(210.2±70.6)ml、产后出血发生率(8.7%),与对照组比较,差异有统计学意义(P<0.05,<0.01,<0.05,<0.01)。结论缩宫素合谷穴位封闭能缩短胎盘娩出时间,减少产后出血量,有效预防宫缩乏力性产后出血的发生,且方法简便易行,明显优于臀部肌肉注射缩宫素,值得临床广泛应用。
Objective To investigate the preventive effect of Hetao point combined with oxytocin on uterine inertia postpartum hemorrhage. Methods Ninety-two maternal women with high risk factors for postpartal uterine atresia were enrolled from January 2013 to December 2013 in Si County People’s Hospital of Anhui Province. They were randomly divided into observation group (46 cases) and control group (46 cases) Closed group) 26 cases of primipara, maternal 20 cases, aged 19 to 40 years, gestational age 37 +2 to 41 weeks, estimated fetal weight 2800 ~ 4250 g. In the observation group, 10 U of oxytocin was occluded in the left or right Hagupar point of the fetus at the time of delivery. The control group (intramuscular injection group) 24 cases of primipara; 22 mothers, aged 20 to 38 years, pregnant Week 37 + 5 ~ 41 + 2 weeks, estimated fetal weight 2900 ~ 4200 g. The control group received a single intramuscular injection of oxytocin 20 U at the buttocks of the fetus when the anterior shoulder was delivered. Postpartum uterine contractions, placental detachment time, vaginal bleeding within 2 h postpartum and postpartum hemorrhage were observed in two groups. Results The observation group had good uterine contractions (effective rate 82.6%), short placental detachment time (3.4 ± 1.6) min, vaginal bleeding amount 210.2 ± 70.6 ml at 2 h postpartum and postpartum hemorrhage rate 8.7% The difference was statistically significant (P <0.05, <0.01, <0.05, <0.01). Conclusions Oxytocin HGT can shorten the delivery time of placenta, reduce the amount of postpartum hemorrhage and prevent the occurrence of uterine inertia postpartum hemorrhage effectively. The method is simple and easy to operate, which is obviously better than injecting oxytocin into intramuscular injection of buttocks, which deserves wide application in clinic.