赵慧赟 杨杨 窦秀清

[摘要] 目的 观察益母草注射液联合缩宫素对预防剖宫产术后产后出血及产后尿潴留的效果。 方法 2015年3～8月，将110例行剖宫产的初产妇随机分为益母草联合缩宫素组（A组）70例、单用缩宫素组（B组）40例。观察两组的术中出血量，术后24 h内总出血量，术后第1、2天子宫收缩情况以及术后拔除导尿管至第1次自行排尿的时间。记录用药期间的不良反应。 结果 A、B组的术中出血量分别为（261.57±41.83）、（277.75±45.66）ml，差异无统计学意义（P>0.05）。A组的术后24 h内总出血量为（301.00±46.28 ）ml，B组为（472.50±79.77）ml，两组差异有统计学意义（P<0.01）；A组术后第1、2天子宫收缩情况优于B组（P<0.01）。A组术后拔除尿管至第1次自行排尿的时间为（154.00±46.04）min，B组为（145.50±41.82）min，但差异无统计学意义（P>0.05）。两组均无明显药物不良反应发生。 结论 益母草注射液联合应用缩宫素在剖宫产术后能有效促进子宫收缩，在预防剖宫产术后出血方面有一定的实用价值，对预防剖宫产术后产后尿潴留的疗效不确切。

[关键词] 剖宫产；产后出血；产后尿潴留

[中图分类号] R714.46 [文献标识码] A [文章编号] 1674-4721（2016）02（b）-0061-04

Curative effect observation of Motherwort injection combined with oxytocin in preventing postpartum hemorrhage and postpartum urinary retention after cesarean section

ZHAO Hui-yun YANG Yang DOU Xiu-qing

Department of the Second Obstetrics，Dandong Women and Children Hospital in Liaoning Province，Dandong 118000，China

[Abstract] Objective To observe the effect of Motherwort injection combined with oxytocin in preventing postpartum hemorrhage and postpartum urinary retention after cesarean section. Methods 100 primipara conducted cesarean section from March to August 2015 were randomly divided into Motherwort injection combined with oxytocin group （group A，n=70），only oxytocin group （group B，n=40）.Bleeding volume during operation，the total bleeding volume after 24 h operation，uterine contraction situation on the first and second day after operation，and the time from postoperative urethral catheter to first self micturition in two groups was observed respectively.The adverse reaction during treatment was recored. Results The bleeding volume during operation in group A and group B was （261.57±41.83） ml and （277.75±45.66） ml respectively，and the difference had no statistical significance （P>0.05）.The total bleeding volume after 24 h operation in group A and group B was （301.00±46.28） ml and （472.50±79.77） ml respectively，and the difference was statistical significance （P<0.01）.Uterine contraction situation at the first and second day after operation in group A was better than that of group B respectively （P<0.01）. The the time from postoperative urethral catheter to first self micturition in group A and group B was （154.00±46.04） min and （145.50±41.82） min respectively，and the difference had no statistical significance （P>0.05）.Both of two groups had any obvious drug adverse reaction. Conclusion Motherwort injection combined with oxytocin can promote uterine contraction effectively after caesarean section，and has some practical value in preventing postpartum hemorrhage after cesarean section，but is not sure in preventing postpartum urinary retention after cesarean section.

[Key words] Cesarean section；Postpartum hemorrhage；Postpartum urinary retention

近年来，随着我国“二胎”政策的开放，剖宫产的总体数量有可能上升。产后出血是剖宫产术后危险性高的并发症[1]，是导致全球孕产妇死亡的主要原因[2]。产后出血导致的孕产妇死亡多发生在产后 24～48 h[3]。即使抢救成功，也可能发生希恩综合征（Sheehan syndrome），所以需要重视。剖宫产术后尿潴留也是产科常见的并发症之一，如果处理不恰当，可影响子宫收缩，引起产后大出血和泌尿系统感染。为了证明益母草（Motherwort）注射液联合缩宫素（oxytocin）在剖宫产术后预防产后出血和产后尿潴留的有效性和安全性，本文对丹东市妇女儿童医院产科行剖宫产分娩的产妇采用随机对照方法进行前瞻性临床疗效研究，现报道如下。