宋敏 王艳香

【摘要】 目的：探讨在催产素引产中应用静点葡萄糖酸钙的临床效果。方法：选取2016年5月-2017年5月本院接收的68例初产妇，均符合引产指征，将入选者随机分为对照组（n=34，采取催产素引产）与观察组（n=34，静点葡萄糖酸钙联合催产素进行引产）。观察两组产妇产后2 h和24 h出血量、產前和产后24 h血红蛋白及变化情况;引产效果;产程、分娩方式、新生儿及胎儿情况，包括新生儿体质量、5 min Apgar评分、胎儿窘迫、新生儿窒息情况以及静脉点滴10%葡萄糖酸钙后产妇的不良反应发生情况。

结果：观察组引产成功率、阴道分娩率均高于对照组，差异均有统计学意义（P<0.05）。观察组第一、二产程均短于对照组（P<0.05），产后2、24 h出血量均少于对照组（P<0.05），24 h血红蛋白下降值低于对照组（P<0.05）。两组新生儿体质量、5 min Apgar评分、胎儿窘迫率比较，差异均无统计学意义（P>0.05）;观察组新生儿窒息率低于对照组，差异有统计学意义（P<0.05）。观察组产妇静脉点滴10%葡萄糖酸钙后，无全身发热、心律失常等不良反应发生，耐受性较好。结论：在催产素引产中静点葡萄糖酸钙，能够提高引产效果，缩短产程，减少产后出血，降低剖宫产率，且使用简便、安全、经济，值得在临床上广泛使用。

【关键词】 葡萄糖酸钙; 催产素; 引产; 产后出血量; 产程; 分娩方式

Study on the Synergistic Effect of Static Calcium Gluconate on Oxytocin Induction/SONG Min，WANG Yanxiang.//Medical Innovation of China，2019，16（08）：0-032

【Abstract】 Objective：To investigate the clinical effect of static Calcium Gluconate in the induction of labor by Oxytocin.Method：From May 2016 to May 2017，68 primipara admitted to our hospital were selected，all of which met the indicators of induced labor.The selected subjects were randomly divided into control group（n=34，induced labor with Oxytocin）and observation group（n=34，induced labor with static Calcium Gluconate combined with Oxytocin）.Postpartum blood loss at 2 and 24 h，prenatal and postpartum 24 h hemoglobin and changes，effect of induced labor，labor process，delivery mode，neonatal and fetal conditions，it included neonatal body mass，5 min Apgar score，fetal distress，neonatal asphyxia of the two groups were compared，and maternal adverse reactions after intravenous drip of 10% Calcium Gluconate were observed.Result：The success rate of labor induction and vaginal delivery rate in the observation group were higher than those in the control group，the differences were statistically significant（P<0.05）.The first and second stages of labor in the observation group were shorter than those in the control group（P<0.05），the postpartum blood loss at 2 and 24 hours were less than those in the control group（P<0.05），and the decrease value of hemoglobin at 24 hours was lower than that in the control group（P<0.05）.There were no significant differences in neonatal body mass，5 min Apgar score and fetal distress rate between the two groups（P>0.05）.The rate of neonatal asphyxia in the observation group was lower than that in the control group，the difference was statistically significant（P<0.05）.After intravenous drip of 10% Calcium Gluconate in the observation group，no systemic fever，arrhythmias and other adverse reactions occurred，with good tolerance.Conclusion：Calcium Gluconate can improve labor induction，shorten labor process，reduce postpartum hemorrhage，and reduce cesarean section rate，it is simple，safe，and economical to use in clinical practice.

【Key words】 Calcium Gluconate; Oxytocin; Labor induction; Postpartum bleeding volume; Labor stage; Delivery mode

First-authors address：Jiamusi Maternal and Child Health Hospital，Jiamusi 154000，China

doi：10.3969/j.issn.1674-4985.2019.08.008

催產素是临床产科常用于催产及引产的药物，具有发动和加强子宫收缩的作用。但单独采取催产素，由于部分产妇对催产素的敏感性较差，因而难以诱发子宫收缩，启动产程。近年来文献[1-2]研究发现，子宫收缩与钙浓度有密切联系。而妊娠期需钙量增加，雌激素升高影响母体骨钙重吸收及血容量增多，导致孕期血钙降低，并随着妊娠周期的增加而逐步下降，因此孕妇大多处于低钙状态。子宫平滑肌细胞收缩，需磷酸化肌浆蛋白、肌动蛋白参与及能量供应，ATP酶及肌浆蛋白轻链激酶不足、平滑肌细胞内钙浓度降低均会影响子宫平滑肌收缩，子宫收缩无力，则会延长产程，增加产后出血的发生率，还会增加新生儿窒息的风险。……