目的 研究宫腔内置入米索前列醇对妊高症剖宫产后出血的防治作用,为临床诊疗提供一定的理论依据.方法 临床入选138例行剖宫产术的妊高症患者,按照入院先后顺序,根据随机数字法分成2组,每组69例.其中对照组在产后宫体注射催产素20 U,术后维持静滴催产素;治疗组则在产后宫腔内置入400 mg米索前列醇.观察分析两组治疗后的相关临床资料.结果 在手术前及术后5 h,两组之间的收缩压(SBP)和舒张压(DBP)均无统计学差异(P＞0.05);而在术后1 h、2 h,研究组的SBP和DBP均较对照组显著降低(P＜0.05).对照组产后出血量为(272.8±133.4)ml,按照产后2 h内出血量≥400 ml诊断为产后出血,产后出血有7例,其发生率为10.14%;而研究组产后出血量为(180.3±101.7)ml,产后出血有2例,其发生率为2.90%,两组在产后出血量和产后出血发生率方面具有统计学差异(P＜0.05).两组患者在药物毒副作用方面没有统计学差异(P＞0.5).结论 采用米索前列醇宫腔直接置入方法防治剖宫产的妊高症患者产后出血效果明确,毒副作用少,操作简单易行,可优先考虑采用.%Objective To investigate the preventative effect of misoprostol inserted into uterine cavity on hemorrhage after uterine - incision delivery in patients with pregnancy induced hypertension. Methods 138 patients with pregnancy induced hypertension and receiving the uterine - incision delivery were clinically selected and randomly divided into two groups with 69 ones in each group according to the order of hospitalization. The control group received injection with 20 U oxytocin into uterus and also the intravenous drip with oxytocin after the operation. The research group received the insertion of 400 mg misoprostol into the uterine cavity after the delivery. The clinical data of the two groups were observed and analyzed. Results Before and 5 h after the operation, there was no significant difference in the systolic blood pressure ( SBP ) and diastolic blood pressure ( DBP ) between the two groups ( P > 0. 05 ). But 1 and 2 h after the operation, compared with the SBP and DBP of the control group, those of the research group significantly decreased ( P<0.05 ). The volume of bleeding after the delivery in the control group was ( 272. 8 ± 133. 4 ) ml. According to the criteria that patients with the volume of bleeding within 2 h after the delivery equal to or more than 400 ml should be diagnosed as postpartum hemorrhage, there were 7 cases of that symptom with the incidence rate of 10. 14%. The volume of bleeding after the delivery was ( 180. 3 ±101.7) ml in the research group, and there were 2 cases of postpartum hemorrhage with the incidence rate of 2. 90% . There were significant differences in the volume and the incidence of postpartum hemorrhage between the two groups( P < 0.05 ). There was no significant difference in the side effects between the two groups ( P > 0. 05 ). Conclusion The preventative effects of misoprostol inserted into uterine cavity is obvious on postpartum hemorrhage in patients with pregnancy induced hypertension. It has advantages of less side effects and simple operation, which should be the preferred choice.
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