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目的探讨米索前列醇联合缩宫素在临床上用于预防减少瘢痕子宫剖宫产产后出血的效果。方法选取2013年1月至2013年12月范县人民医院产科有子宫手术史的剖宫产产妇80例,随机分为观察组和对照组,每组40例,两组产妇均采用改良式剖宫产法,麻醉方法为腰硬联合麻醉,观察组在胎儿娩出后立即舌下含服米索前列醇400μg,同时静脉滴注缩宫素,对照组仅静脉注射缩宫素,出血量计算用称重法,对比两组产妇的术中出血量、术后24 h出血量、产后出血发生率等指标。结果两组术中出血量、术后24 h出血量、产后出血发生率比较差异有统计学意义(P<0.05或0.01)。结论米索前列醇联合缩宫素促进子宫收缩作用明显,对于预防瘢痕子宫剖宫产大出血的发生率,降低其孕产妇病死率十分有效,值得临床推广和应用。
Objective To investigate the effect of misoprostol combined with oxytocin in the prevention of bleeding after cesarean section in scarred uterus. Methods From January 2013 to December 2013, 80 cases of cesarean section with history of uterus in obstetrics and gynecology of Fanxian People’s Hospital were randomly divided into observation group and control group, with 40 cases in each group. Both groups adopted modified cesarean section Palace method, anesthesia for the joint spinal anesthesia, the observation group immediately after delivery of fetus sublingual misoprostol 400μg, while oxytocin intravenous infusion, the control group only intravenous oxytocin, the amount of bleeding calculated Weighing method, comparing the two groups of maternal intraoperative blood loss, 24 h postoperative bleeding, the incidence of postpartum hemorrhage and other indicators. Results The intraoperative blood loss, the amount of hemorrhage after 24 hours and the incidence of postpartum hemorrhage were significantly different between the two groups (P <0.05 or 0.01). Conclusion Misoprostol and oxytocin promote uterine contractility significantly. It is very effective in preventing the incidence of cesarean section bleeding and reducing the maternal mortality rate, which is worthy of clinical promotion and application.