催产素与麦角新碱联合催产素在分娩第三期预防产后出血的比较

Thitipun Nuamsiri, Kasemsis Kaewkiattikun
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引用次数: 4

摘要

目的:探讨在标准催产素输注基础上静脉加用麦角新碱对阴道分娩出血量的影响。研究设计:前瞻性、双盲、随机对照试验。材料与方法:随机选取323名妇女,在分娩后立即输注麦角新碱0.2 mg加催产素20 IU或催产素20 IU,稀释于1000 ml 5%D/N/2中。主要结果是估计的失血量。次要结局包括PPH、血红蛋白水平变化、额外子宫强张剂的使用、输血需求和不良反应。结果:催产素-麦角新碱组和催产素组产后出血量相近(145 ml vs 150 ml, p=0.979)。催产素-麦角新碱组中没有女性出现PPH,而催产素组中有一名女性(0.6%)出现PPH并发症(p=0.498)。两组在血红蛋白水平变化、使用额外子宫强张剂和输血需求方面无显著差异。催产素-麦角新碱组高血压发生率明显高于催产素组(6.2% VS 0%, p< 0.001)。结论:催产素-麦角新碱组和催产素组阴道分娩时的产后出血量无差异。催产素-麦角新碱组常出现高血压。然而,其他不良反应在两组间无显著差异。
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Prevention of Postpartum Hemorrhage with Oxytocin versus Ergometrine Plus Oxytocin in the third stage of labor
Objective :  To evaluate the effect of the addition of intravenous ergometrine to a standard oxytocin infusion on the blood loss during vaginal delivery. Study design :  Prospective, double-blinded, randomized controlled trial. Materials and methods : Three hundred and twenty-three women were randomized to receive infusion of either ergometrine 0.2 mg plus oxytocin 20 IU or oxytocin 20 IU, diluted in 1,000 ml of 5%D/N/2, immediately after delivery of the baby. The primary outcome was the estimated blood loss. The secondary outcomes included PPH, changes in hemoglobin level, the use of additional uterotonics, need for blood transfusion and adverse effects. Results :  The estimated postpartum blood loss was similar in the oxytocin–ergometrine and oxytocin groups (145 ml versus 150 ml, p=0.979). None of the women in the oxytocin–ergometrine group had PPH while one woman (0.6%) in the oxytocin group encountered this complication (p=0.498). There was no significant difference between both  groups  in  terms of changes in hemoglobin level, use of additional uterotonics and need for blood transfusion. Hypertension was significantly more common in the oxytocin–ergometrine group than in the oxytocin group (6.2% VS 0%, p< 0.001). Conclusions :  There was no difference in postpartum blood loss during vaginal delivery between oxytocin–ergometrine and oxytocin groups. Hypertension was frequently found in the oxytocin–ergometrine group. However, other adverse effects were not significantly different between both groups.
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来源期刊
Thai Journal of Obstetrics and Gynaecology
Thai Journal of Obstetrics and Gynaecology Medicine-Obstetrics and Gynecology
CiteScore
0.40
自引率
0.00%
发文量
3
审稿时长
24 weeks
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