【摘要】：目的觀察米索前列醇、縮宮素鼻噴劑及卡前列甲酯栓對(duì)普通足月陰道分娩患者產(chǎn)后出血量的臨床療效及其對(duì)雌激素、一氧化氮(NO)及一氧化氮合酶(NOS)的影響。方法收集我院收治的普通足月陰道分娩的患者600例,隨機(jī)分為A組、B組和C組,每組各200例。A組給予縮宮素鼻噴劑,每噴0.1 mL,每側(cè)鼻孔各2噴,每日2次,B組舌下含化米索前列醇200μg,C組給予卡前列甲酯栓1 mg,塞肛。治療后,比較3組患者血清中雌二醇(E_2)、NO及NOS水平、出血量,觀察3組患者的臨床療效和藥物不良反應(yīng)發(fā)生情況。結(jié)果治療后,A組總有效率為76.50%(153/200例),B組為86.00%(172/200例),C組為90.50%(181/200例),C組與A組比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。治療后,A、B、C組E_2分別為(14.75±2.09),(17.63±2.15),(21.82±3.09)nmol·L~(-1);NO分別為(107.83±11.21),(92.42±10.17),(79.25±9.89)nmol·L~(-1);NOS分別為(25.64±3.11),(22.56±3.05),(19.63±2.28)nmol·L~(-1)(P0.05)。A、B、C組2 h內(nèi)出血量分別為(712.43±40.85),(632.43±42.77),(580.74±37.64)mL;2~24 h出血量分別為(138.92±17.86),(126.94±12.93),(103.85±11.13)mL(P0.05)。A組藥物不良反應(yīng)有鼻腔刺激反應(yīng)、鼻出血,藥物不良反應(yīng)發(fā)生率為1.50%(3/200例);B組藥物不良反應(yīng)有輕度惡心、嘔吐、眩暈,藥物不良反應(yīng)發(fā)生率為2.50%(5/200例);C組藥物不良反應(yīng)有腹瀉、惡心嘔吐,藥物不良反應(yīng)發(fā)生率為2.00%(4/200例),差異無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論與米索前列醇、縮宮素鼻噴劑治療比較,卡前列甲酯栓能夠更顯著提高普通足月陰道分娩患者血清E_2水平,降低血清NO、NOS水平,減少出血量,且安全性較高。
[Abstract]:Objective to observe the clinical effect of misoprostol, oxytocin nasal spray and carprost methyl ester suppository on postpartum hemorrhage and the effects of misoprostol, oxytocin nasal spray and carprost methyl ester suppository on estrogen, nitric oxide (NO) and nitric oxide synthase (NOS). Methods 600 cases of normal term vaginal delivery in our hospital were randomly divided into three groups: group A, group B and group C. Group A received oxytocin nasal spray with 2 sprays per 0. 1 mL, each side of nostril. Two times a day, group B was given methyl carprost suppository for 1 mg, to plug anus in group C with 200 渭 g of misoprostol. After treatment, the serum levels of estradiol (E _ 2), NO and NOS) and blood loss were compared among the three groups, and the clinical efficacy and adverse drug reactions were observed. Results after treatment, the total effective rate of group A was 76.50% (153 / 200 cases of), B group was 86.00% (172 / 200 cases of), C group was 90.50%) (181% of 200 cases of), C group compared with group A), the difference was statistically significant (P0.05). 娌葷枟鍚，

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