不同剂量的马来酸麦角新碱预防产后出血的效果分析-现代医学

不同剂量的马来酸麦角新碱预防产后出血的效果分析

单位：1. 南京医科大学附属南京医院(南京市第一医院)妇产科, 江苏南京 210006;
2. 南京医科大学护理学院, 江苏南京 211166

分类号：R714.461

出版年·卷·期（页码）：2021·49·第四期（429-434）

摘要：

目的：研究不同剂量麦角新碱联合缩宫素对剖宫产产后出血及血压的影响。方法：本研究分为3组：对照组（n=60）仅予缩宫素，研究1组（n=60）娩胎盘后额外麦角新碱0.2 mg宫体注射，研究2组（n=90）娩胎盘后额外麦角新碱0.4 mg宫体注射，记录出血量、血红蛋白及血压。3组之间行方差分析，多时间点数据行重复测量分析，计数资料行卡方检验。结果：3组一般情况及术前血红蛋白水平比较，差异无统计学意义。术中、术后2 h及24 h出血量，术后血红蛋白水平在研究1、2组均少于对照组。但研究1、2组组间上述指标比较，差异无统计学意义。结论：麦角新碱联合缩宫素使用可降低剖宫产产后出血，使用0.2 mg或0.4 mg麦角新碱对剖宫产产后出血量无明显改变。

Objective: To study the effect of different doses of ergometrine maleate combined with oxytocin on blood loss and blood pressure after cesarean section.Methods: The study was divided into 3 groups:the control group(n=60) received oxytocin only. On the basis of the control group, in the study group 1(n=60),0.2 mg ergometrine maleate was injected into the uterus after the placenta was delivered. Study 2 group(n=90) on the basis of the control group, 0.4 mg ergometrine maleate uterine injection was done after delivery of the placenta. The blood loss, hemoglobin and the blood pressure were recorded. Analysis of variance, repetitive measure analysis and Chi-square test were used in this study.Results: There were no differences in general situation and hemoglobin level before cesarean section. However, the intraoperative bleeding and the blood loss 2 h, 24 h after surgery, and the hemoglobinlevels after surgery in the two study groups were less than those in the control group. There were no significant differences in the above targets between the two study groups with different dosages of ergometrine maleate.Conclusion: The use of ergometrine maleate combined with oxytocin can significantly reduce postpartum hemorrhage after cesarean section. However, the preventive use of 0.2 mg or 0.4 mg of ergometrine maleate has no significant effect on reducing post-operative blood loss.

参考文献：

[1] 谢幸,孔北华,段涛.妇产科学[M].9版.北京:人民卫生出版社,2018:204-209.
[2] MASWIME S,BUCHMANN E.A systematic review of maternal near miss and mortality due to postpartum hemorrhage[J].Int J Gynaecol Obstet,2017,137(1):1-7.
[3] KANDEEL M,SANAD Z,ELLAKWA H,et al. Management of postpartum hemorrhage with intrauterine balloon tamponade using a condom catheter in an Egyptian setting[J].Int J Gynecol Obstet,2016,135(3):272-275.
[4] 赵丽琴,郭遂群,林丹.缩宫素引产持续时间与宫缩乏力性产后出血的相关性[J].现代医学,2013, 41(5):332-335.
[5] 金荣,石少权.麦角新碱联合缩宫素治疗临产后剖宫产产后出血的临床观察[J].药物评价研究,2018,41(2):302-304.
[6] 钟柳英,陈敦金,纪艳洁,等.麦角新碱预防高危孕产妇剖宫产出血的疗效观察[J/OL].中华产科急救电子杂志,2018,7(3):180-184.
[7] 张奕晖,顾宁,王志群等.运用十分类系统探索我国计划生育政策改变对剖宫产的影响[J].中华围产医学杂志,2017,20(9):696.
[8] 潘凤英.不同剂量缩宫素用于预防产后出血效果分析[J].白求恩医学杂志,2015,13(1):64-65.
[9] 蔡本硕,杜鹃.某医院前置胎盘患者术中出血相关因素的回顾性分析[J].东南大学学报(医学版),2018,37(5):908-911.
[10] 张力,刘兴会.产后出血的药物治疗评价[J].中国实用妇科与产科杂志,2009,25(2):98-102.
[11] 韩小雪,潘颖,董南,等.静脉滴注新麦角新碱预防产后出血对血压的影响[J/OL].妇产与遗传(电子版),2018,8(1):23-26.
[12] TRIPATHI K D.5-Hydroxytryptamine, its antagonists and drug therapy of migraine[M]//TRIPATHI K D. Essential of medical pharmacology.6th ed.New Delhi:Jaypee brothers,2008:162-172.
[13] BATEMAN B T,HUYBRECHTS K F,HERNANDEZ-DIAZ S,et al.Methylergonovine maleate and the risk of myocardial ischemia and infarction[J].Am J Obstet Gynecol,2013,209(5):459.e1-459.e13.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录