麦角新碱预防高危孕产妇剖宫产出血的疗效观察  

Efficacy of ergonovine in preventing hemorrhage of cesarean section in high-risk pregnant women

作　　者：钟柳英[1] 陈敦金[1] 纪艳洁 王刚[3] 侯红瑛 尹保民 代炳梅 张卫社[7] 何东梅 高玲[9] 丁桂凤 朱启英[11] 何津[12] 阴春霞[13] 许吟[14] 高万里 杨金英 Zhong Liuying;Chen Dunjin;Ji Yanjie;Wang Gang;Hou Hongying;Yin Baoming;Dai Bingmei;Zhang Weishe;He Dongmei;Gao Ling;Ding Guifeng;Zhu Qiying;He Jin;Yin Chunxia;Xu Yin;Gao Wanli;Yang Jinying(Department of Obstetrics,Third Affiliated Hospital of Guangzhou Medical University,510150 Guangzhou,China;Department of Obstetrics and Gynecology,Dongguan Tangxia Hospital,523721 Guangdong,China;Department of Obstetrics and Gynecology,Foshan First People＇s Hospital,528000 Guandong,Chin;Department of Obstetrics,iBorn Women＇s ＆ Chidren＇s Hospital,510635 Guangzhou,Chin;Department of Obstetrics and Gynecology,Zhuhai Maternal and Child Health Hospital,519001 Guangdong,China;Department of Obstetrics and Gynecology,Dongguan Maternal and Child Health Hospital,523112 Guangdong,Chin;Department of Obstetrics,Central South University Xiangya Hospital,410008 Changsha,Chin;Department of Obstetrics and Gynecology,BING TUAN DI SI SHI YI YUAN,835000 Yining,China;Department of Obstetrics and Gynecology,First Agricultural Division Of Xinjiang Production And Construction Corps,843000 Aksu,Chin;epartment of Obstetrics and Gynecology,Maternal and Child Health Care Hospital of Xinjiang Uygur Autonomous Region 830001 Urumqi,Chin;epartment of Obstetrics,First Affiliated Hospital of Xinjiang Medical University,830054 Urumqi,Chin;epartment of Obstetrics and Gynecology,Jilin University Bethune First Hospital,130021 Changchun,Chin;epartment of Obstetrics and Gynecology,Changchun Obstetrics and Gynecology Hospital,140052 Changchun,Chin;epartment of Obstetrics and Gynecology,Guizhou Provincial People＇s Hospital,550002 Guiyang,Chin;epartment of Obstetrics and Gynecology,Daxing District People＇s Hospital,102600 Beijing,Chin;epartment of Obstetrics and Gynecology,Harbin Nangang District Obstetrics and Gynecology Hospital,150080 Harbin,China)

机构地区：[1]广州医科大学附属第三医院产科,510150 [2]东莞塘厦医院妇产科,广东523721 [3]佛山市第一人民医院妇产科,广东528000 [4]中山三院爱博恩医疗中心产科,广州510635 [5]珠海妇幼保健院妇产科,广东519001 [6]东莞妇幼保健院妇产科,广东523112 [7]中南大学湘雅医院妇产科,长沙410008 [8]新疆生产建设兵团农四师医院妇产科,伊宁835000 [9]新疆生产建设兵团农一师医院妇产科,阿克苏843000 [10]乌鲁木齐市妇幼保健院妇产科,830001 [11]新疆医科大学第一附属医院妇产科,乌鲁木齐830054 [12]吉林大学白求恩第一医院产科,长春130021 [13]长春市妇产医院产科,140052 [14]贵州省人民医院产科,贵阳550002 [15]北京大兴区人民医院妇产科,102600 [16]哈尔滨南岗区妇产医院产科,哈尔滨150080

出　　处：《中华产科急救电子杂志》2018年第3期180-184,共5页Chinese Journal of Obstetric Emergency（Electronic Edition）

摘　　要：目的评估麦角新碱预防高危孕妇剖宫产术中及术后出血的有效性和安全性。方法收集2017年2月至6月就诊于全国16家医院具有出血高危因素行剖宫产术的产妇1074例。按使用不同宫缩将患者分成3组,研究组Ⅰ(384例,术中注射缩宫素+麦角新碱,术后注射缩宫素),研究组Ⅱ(340例,术中注射缩宫素+麦角新碱,术后注射麦角新碱),对照组(350例,术中和术后注射缩宫素),比较各组术中、术后2 h及术后24 h出血量及药物副作用的情况。采用方差分析和2检验对数据进行统计学分析。结果研究组Ⅱ术中出血量,术后2 h和术后24 h出血增量分别为(400. 09±203. 82) ml、(31. 76±27. 83) ml和(60. 74±55. 27) ml,明显低于研究组Ⅰ的(451. 33±441. 43) ml、(66. 30±43. 08) ml和(83. 62±56. 89) ml,差异均有统计学意义(P <0. 05)。研究组Ⅱ使用治疗性宫缩剂为18例(5. 29%),分别低于研究组Ⅰ89例(23. 18%)和对照组102例(29. 14%),q=3. 90和4. 32,差异均有统计学意义(P <0. 05)。结论麦角新碱预防高危孕产妇剖宫产术中和术后出血安全有效,但药物不良反应要密切注意。Objective To evaluate the curative effect and safety of ergonovine in preventing bleeding during and after cesarean section in high risk pregnant women. Methods One thousand and seventy-four parturients with high risk factors of bleeding who underwent cesarean section in 16 hospitals of China were collected from February to June 2017. Patients were divided into three groups according to the use of different uterine contraction agents： group Ⅰ （384 cases, oxytocin plus ergonovine were injected intraoperatively, oxytocin was injected after operation）, group Ⅱ （340 cases, oxytocin plus ergonovine were injected intraoperatively, ergonovine was injected after operation）, control group （350 cases, oxytoein was injected intraoperatively and after operation）. The bleeding volume and side effects of the operation, 2 h and 24 h after operation were analyzed and compared. Analysis of variance or Chi-square test was used for statistical analysis. Results In group Ⅱ, the amount of blood loss of the operation, 2 h and 24 h after operation were （400. 09 ± 203.82 ） ml, （ 31.76 ± 27. 83 ） ml, （60. 74 ± 55.27 ） ml, respectively, which were significantly less than those in group Ⅰ （451.33 ±441.43 ） ml, （66. 30 ± 43.08 ） ml, （ 83.62 ± 56. 89）ml, （P 〈0. 05）. The incidence rate of the patients used uterine contraction agent in group Ⅱ was 5.29% （18 cases）, which was smaller than those in group Ⅰ （23.18%, 89 cases） and in the control group （29. 14%, 102 cases） , q = 3.90 and 4. 32, respectively, and P less than 0. 05. Conclusion Ergonovine was effective and safe for high risk pregnant women with cesarean section to prevent intraoperative hemorrhage and postoperative hemorrhage, but close attention should be paid to the adverse drug reaction.

关 键 词：麦角新碱 剖宫产术 妊娠 高危 

分 类 号：R719.8[医药卫生—妇产科学]