张鹏,陈爱华,高晓艳,张玲,佐满珍
ZHANG Peng,CHEN Aihua,GAO Xiaoyan,ZHANG Ling,ZUO Manzhen

• 1:三峡大学人民医院妇产科
• 2:三峡大学人民医院超声影像科

摘要(Abstract)：

目的:观察垂体后叶素治疗剖宫产术后宫腔积血的临床疗效。方法:将162例剖宫产术后发生宫腔积血的产妇随机分为观察组和对照组,观察组肌注垂体后叶素,对照组肌注缩宫素,观察宫腔积血的治疗效果、子宫复旧情况及用药后的不良反应。结果:两组阴道出血时间比较,观察组短于对照组,差异有统计学意义(P<0.01);与对照组比较,术后第14天观察组宫腔积血明显减少,清宫率显著降低(χ2=6.39,P<0.05);观察组的子宫复旧明显好于对照组,宫腔积血治愈率达到91.4%(74/81),高于对照组的(77.8%,63/81);观察组5例产妇呕吐,治疗组10例出现恶心、呕吐、腹泻。结论:垂体后叶素子宫肌注治疗剖宫产术后宫腔积血效果显著。
Objective: To investigate clinical effect of pituitrin therapy on hematometra after cesarean section. Methods: A total of 162 patients with hematometra after cesarean section were randomly divided into observation group and control group. They were injected intramuscularly with pituitrin( observation group) or oxytocin( control group). Observing treatment effect of hematometra,involution of uterus and adverse reaction after treatment. Results: Comparing vaginal bleeding time,observation group was significantly shorter than control group,differences were statistical significant( P < 0. 01);14 days after surgery,hematometra of observation group reduced significantly,curettage rate decreased remarkably( χ2= 6. 39,P < 0. 05); involution of uterus in observation group was also significantly better than control group,hemorrhage cure rate was 91. 4%( 74 /81),higher than that of control group( 77. 8%,63 /81). 5 patients of observation group vomited,10 patients of control group were nausea,vomited and diarrhea. Conclusion: The effect of pituitrin treatment on hematometra after cesarean section is remarkable.

关键词(KeyWords)： 垂体后叶素;剖宫产术;子宫积血;子宫复旧
pituitrin;cesarean section;hematometra;uterine involution

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金(31260248);; 宜昌市卫生科技项目(A14301-21)

作者(Author): 张鹏,陈爱华,高晓艳,张玲,佐满珍
ZHANG Peng,CHEN Aihua,GAO Xiaoyan,ZHANG Ling,ZUO Manzhen

DOI: 10.19367/j.cnki.1000-2707.2015.04.015

参考文献(References)：

• [1]Bergenhenegouwen LA,Meertens LJ,Schaaf J,et al.Vaginal delivery versus caesarean section in preterm breech delivery:a systematic review[J].European Journal of Obstetrics,Gynecology,and Reproductive Biology,2014(172):1-6.
• [2]Roberts CL,Nicholl MC,Algert CS,et al.Rate of spontaneous onset of labour before planned repeat caesarean section at term[J].BMC Pregnancy and Childbirth,2014(14):125.
• [3]Li J,Yu YX,Zheng LY,et al.[Clinical research on bilateral arcuate artery suture hemostasis of corpus uteri for postpartum hemorrhage due to uterine inertia during caesarean section][J].Zhonghua Fu Chan Ke Za Zhi,2013(3):165-170.
• [4]肖欢.益宫颗粒联合缩宫素治疗剖宫产术后宫腔积血的临床疗效分析[J].浙江创伤外科杂志,2014(2):193-194.
• [5]Pearson GA,Mac Kenzie IZ.Blood loss and blood transfusion at caesarean section:a prospective observational study covering 30 years[J].European Journal of Obstetrics,Gynecology,and Reproductive Biology,2014(181C):72-77.
• [6]Brown HK,Hill J,Natale R.Caesarean section rates in southwestern ontario:changes over time after adjusting for important medical and social characteristics[J].Journal of Obstetrics and Gynaecology Canada:JOGC=Journal D'obstetrique Et Gynecologie Du Canada:JOGC,2014(7):578-589.
• [7]Gama SG,Viellas EF,Schilithz AO,et al.Factors associated with caesarean section among primiparous adolescents in Brazil,2011-2012[J].Cadernos De Saude Publica,2014(Suppl 1):S117-S127.
• [8]Ismail S,Siddiqui S,Shafiq F,et al.Blood transfusion in patients having caesarean section:a prospective multicentre observational study of practice in three Pakistan hospitals[J].International Journal of Obstetric Anesthesia,2014(3):253-259.
• [9]付景丽,郑剑兰,张小琼.剖宫产后出血的临床分析[J].现代妇产科进展,2012(3):215-217.
• [10]Graham N,Mahoney C,Dickson M.Risk factors for surgical site infection following caesarean section in England[J].BJOG:an international journal of obstetrics and gynaecology,2013(4):509.
• [11]Gregson H.Reducing surgical site infection following caesarean section[J].Nurs Stand,2011(50):35-40.
• [12]Ajmal M.Oxytocin at caesarean section-are we giving too much?[J].BJOG:an international journal of obstetrics and gynaecology,2010(1):118-119;author's reply 119.
• [13]Larciprete G,Montagnoli C,Frigo M,et al.Carbetocin versus oxytocin in caesarean section with high risk of post-partum haemorrhage[J].Journal of Prenatal Medicine,2013(1):12-18.
• [14]Pursche T,Diedrich K,Banz-Jansen C.Blood loss after caesarean section:depending on the management of oxytocin application?[J].Archives of Gynecology and Obstetrics,2012(3):633-636.
• [15]Weale N,Laxton C.Prophylactic use of oxytocin at caesarean section:where are the guidelines?[J].Anaesthesia,2013(10):1006-1009.
• [16]Gao Y,Du G,Wu Y,et al.[Protective effect and mechanisms of pituitrin on acute paraquat-induced lung injury in rats][J].Zhonghua Yi Xue Za Zhi,2014(4):306-309.
• [17]温兰英,张桂芬,齐爱英.垂体后叶素预防产后出血200例临床分析[J].中国现代药物应用,2008(16):75-76.
• [18]蒋俐华,吴竟,金海英,等.垂体后叶素、米索前列醇和缩宫素联合治疗产后出血的临床观察[J].中国医药科学,2013(19):87-89.
• [19]冯建萍,王静云,蒋秀红.垂体后叶素在腹腔镜下子宫肌瘤剔除术中血流动力学影响的研究[J].实用临床医药杂志,2010(21):126-127.
• [20]Zhang Z,Shi HW,Sun JH,et al.Use of hypophysin in hypotensive patients with low systemic vascular resistance following cardiopulmonary bypass[J].International Journal of Clinical Pharmacology and Therapeutics,2013(8):615-619.

文章评论(Comment)：