摘要
目的探讨宫缩乏力性产后出血应用欣母沛治疗的临床效果。方法选取产科住院患者35例,胎儿娩出后,自然分娩者行20U缩宫素肌注,剖宫产者常规静脉滴注20U,并行缩宫素20U注射。上述治疗方法无效者,在排除凝血机制、胎盘因素、软产道损伤等因素后,给予分娩者米索前列醇片600μg口服,并行持续子宫按摩。15~30 min之后仍未快速见效者,及时给予250μg欣母沛进行治疗,剖宫产者术中直接行宫体肌注,阴道分娩者经宫颈注射,如一次治疗未见明显效果,可进行多次注射,每次注射时间间隔为15 min以上,不能超过2 mg总量。结果单次注射欣母沛250μg,15 min内子宫出现明显收缩、出血量减少的产妇有32例,显效率为91.4%。一次未见明显效果重复注射欣母沛250μg,阴道出血量减少,子宫收缩逐渐加强,其中1例产妇使用欣母沛500μg,其中1例产妇使用欣母沛750μg,有效率为5.7%,总有效率为97.1%。1例产妇完全性前置胎盘,宫缩性乏力严重,出血量约2 500 ml,反复注射欣母沛几次无效,后因凝血功能障碍,改行子宫次全切除。结论欣母沛具有方便、迅速、安全、高效等优点,对于控制宫缩乏力性产后出血有很好的疗效,值得临床推广应用。
Objective To investigate the effect of hemabate in postpartum hemorrhage caused by uterine atony. Methods The 35 patients who had postpartum hemorrhage caused by uterine atony were given conventional hemostasis therapy（ those who given nature birth received muscle injection of oxytocin at the dose of20 U,however,those who give birth though uterine-incision delivery were given oxytocin at the dose of 20 U through intravenous drip）,if this without response and the reasons like clotting mechanism,placental related factors and soft birth canal injury were removed,the patients were given Misoprostol at the dose of 600μg. When it without response again they were given an injection of hemebate. The time interval between multiple doses was about 15 minutes. The total dose should not exceed 2mg. Results After single injection of hemebate at the dose of 250μg,32 cases of puerpera performed obvious uterus shrink and the decreasing bleeding amount in 15 minutes,the obvious effective rate was 91. 4%. 34 of 35 patients achieved good effect,the effective rate was 97.1%. One cases of puerpera received 500μg and one case of puerpera received 750μg of hemebate before they performed obvious uterus shrink,the total effective rate was 97. 1%. There was one case of placenta previa which performed uterine atony,she received subtotal hysterectomy because of clotting mechanism problem. Conclusions Hemebate is effective in the treatment of postpartum hemorrhage caused by uterine atony,it is worthy of clinical application.
出处
《齐齐哈尔医学院学报》
2015年第21期3147-3149,共3页
Journal of Qiqihar Medical University
关键词
宫缩乏力
欣母沛
产后出血
Uterine atony
Hemebate
Postpartum hemorrhage
