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目的探讨催产素联合安列克在预防剖宫产产后出血方面应用的有效性与安全性,为临床预防产后出血提供相应依据。方法收集2010年12月至2012年12月在我院收治的180例有剖宫产指征且有宫缩乏力高危因素的孕妇作为研究对象。随机分为对照组90例和观察组90例,对照组给予常规催产素预防方案治疗,观察组则给予催产素联合安列克预防措施治疗。比较2组术中出血量、术后2h及24h出血量、产后出血发生率、血红蛋白下降值及副反应发生率。结果对照组术中出血量、术后2h出血量、术后24h出血量分别为(361±57)mL、(431±92)mL、(464±54)mL、产后出血发生率为33.3%;观察组术中出血量、术后2h出血量、术后24h出血量分别为(223±48)mL、(301±49)mL、(316±58)mL、产后出血发生率为11.1%。观察组术中出血量、术后2h出血量及24h出血量均少于对照组,P均<0.05,差异均具有统计学意义。观察组产后出血发生率显著低于对照组,P<0.05,差异具有统计学意义。对照组与观察组患者术后24h血红蛋白浓度下降值相比较,观察组下降值更大,P<0.05,差异具有统计学意义。两组副反应发生率相比较,除腹泻无显著差异外,恶心呕吐、心动过速、面部潮红等副反应发生显著多于单独使用催产素组,所有副反应均无需特殊治疗在短期内消失。结论催产素联合安列克预防剖宫产产后出血有效且安全,值得进一步深入探讨研究与推广应用。
Objective To investigate the effectiveness and safety of oxytocin combined with Anlac in the prevention of bleeding after cesarean section and provide a basis for clinical prevention of postpartum hemorrhage. Methods A total of 180 pregnant women with indication of cesarean section and high risk of uterine atony in our hospital from December 2010 to December 2012 were collected. Randomly divided into control group of 90 patients and observation group of 90 patients in the control group were given conventional oxytocin prophylaxis treatment, the observation group was given oxytocin combined with Anlai Ke preventive treatment. The amount of bleeding during operation, the amount of bleeding at 2h and 24h after operation, the incidence of postpartum hemorrhage, the hemoglobin drop and the incidence of side effects were compared. Results The intraoperative blood loss, blood loss at 2h after surgery and postoperative 24h were (361 ± 57) mL, (431 ± 92) mL and (464 ± 54) mL, respectively. The incidence of postpartum hemorrhage was 33.3%. The intraoperative blood loss, blood loss at 2h after surgery and postoperative 24h were (223 ± 48) mL, (301 ± 49) mL and (316 ± 58) mL, respectively. The incidence of postpartum hemorrhage was 11.1%. The bleeding volume in the observation group, the amount of bleeding at 2 hours and the amount of bleeding at 24 hours after operation were all less than those in the control group (all P <0.05). The differences were statistically significant. The incidence of postpartum hemorrhage in observation group was significantly lower than that in control group, P <0.05, the difference was statistically significant. Compared with the decrease of hemoglobin concentration of 24h after operation in control group and observation group, the decrease in observation group was larger, P <0.05, the difference was statistically significant. In addition to no significant difference in the incidence of diarrhea, nausea and vomiting, tachycardia, facial flushing and other side effects occurred significantly more than the use of oxytocin alone, all side effects without special treatment disappear in the short term. Conclusion Oxytocin combined with Anlac is effective and safe in preventing postpartum hemorrhage of cesarean section. It is worth further exploration and application.