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目的:观察欣母沛对合并有产后出血高危因素的剖宫产孕产妇产后出血的防治效果和安全性。方法:选择合并有羊水过多、双胎妊娠、巨大胎儿、宫缩乏力、前置胎盘等产后出血高危因素的孕产妇90例,随机分为对照组(胎儿娩出后只常规静滴催产素)、肌注欣母沛组(胎儿娩出后常规静滴催产素的基础上,同时三角肌内注射欣母沛)、宫体注射欣母沛组(胎儿娩出后常规静滴催产素的基础上,同时子宫肌层内注射欣母沛)各30例。比较各组术中、产后2 h及产后24 h的出血量、产后出血的发生率以及副反应。结果:肌注欣母沛组和宫体注射欣母沛组产后出血的发生率分别为16.7%和13.3%,明显低于对照组的36.7%(P<0.01),两组术中、产后2 h和产后24 h平均出血量也均明显少于对照组,差异有统计学意义(P<0.01),肌注欣母沛组和宫体注射欣母沛组的副反应总发生率明显高于对照组36.7%(P<0.01),肌注欣母沛组的副反应总发生率高于宫体注射欣母沛组(P<0.05)。发生副反应的孕产妇均可自行恢复,无严重并发症发生。结论:对合并有产后出血高危因素的剖宫产孕产妇术中预防性使用欣母沛,明显减少了术中和产后出血量,降低了产后出血的发生率,两种使用方法均疗效确凿、安全性好,值得各级医院推广。
Objective: To observe the effect and safety of Xin-Pei-Pei on postpartum hemorrhage of cesarean section with risk factors for postpartum hemorrhage. Methods: Ninety pregnant women with high risk of polyhydramnios, twin pregnancy, huge fetus, uterine atony and placenta previa were selected and randomly divided into control group (intravenous oxytocin only after delivery) , Intramuscular injection of Xin Maipei group (fetal intravenous infusion of oxytocin based on the same time, deltoid injection Xinma Pei), Palace injection Xinmipei group (after the delivery of conventional intravenous oxytocin on the basis of, At the same time injection of intramuscular injection of Xin Ma Pei) of 30 cases. The intraoperative blood loss, the incidence of postpartum hemorrhage and side effects of 2 h postpartum and 24 h postpartum were compared. Results: The incidence of postpartum hemorrhage was 16.7% and 13.3% in the group of Xinxin Pei and Zhumaimei, respectively, which was significantly lower than that of the control group (36.7%, P <0.01). The intraoperative and postpartum 2 h and 24 h postpartum were also significantly less than the average amount of bleeding in the control group, the difference was statistically significant (P <0.01), intramuscular injection of Xin Maopei group and Xin Fang Pei injection group was significantly higher than the incidence of side effects The control group 36.7% (P <0.01). The total incidence of adverse reactions in intramuscular injection of Xinmian Pei group was higher than that in Xinmi Pei group (P <0.05). Side effects of maternal reactions can be self-healing, no serious complications. Conclusions: Preventive use of Xinma Pei in cesarean section in pregnant women with cesarean section combined with the risk factors for postpartum hemorrhage significantly reduced intraoperative and postpartum hemorrhage and reduced the incidence of postpartum hemorrhage. Both of the two methods were effective, Good safety, it is worth all levels of hospital promotion.