TCNCYH 71 (6J - 2010
thdng can lam sAng va viec sfl dung xet nghiem 2009. Luan I n B I c sy chuyen khoa cap II. Trfldng eua bae sy tai 2 benh vien tinh Nam Djnh nam Dai hpe Y T h i i Binh.
Summary
R E S E A R C H I N G O N I N V E S T I G A T I V E S I T U A T I O N I N P R O V I N C I A L - L I N E HOSPITALS I N V I E T N A M
Objective; determine hospitals' officers, equipments and cataloge about medical investigation at the provincial line hospitals throughout the Viet Nam. Method: The study is performed in 8 provincial line hosptiasl in 8 prdvinces representing 8 areas in Viet Nam, including: Dien Bien, Lang Sen, Ha Nam, Ha Tinh, Khanh Hda, Dae Lac, Binh Phudc and Ddng Thap. Results: about peeple, the rate is tdo low. The lowest rate is in Lang Son general hdsptial, dnly 12 people, Khanh Hoa general hosptial with the highest number, 45 people; about equipment, in general the total is endugh following the resolution of Ministry of Elealth, published 2008; abdut investigative eataldge, the number df investigatien df them is quite enough following standard regulation published 2005 by Ministry of Health. Conclusion: About equipments, in general, there are rather endugh investigative equipments but abdut peeple, ameunt df prdfessional doctors in this branch is tod Idw, so ability of investigation in provincial-line hospitals is ndt meet the demand.
We need to find out the measures selving this problem.
Keywords: Investlgatve system, provincial and district line hospital
SO SANH HIEU QUA CUA DURATOCIN VA OXYTOCIN TRONG GIAI DOAN 3 CUA CHUYEN DA
Dang Thi Minh Nguyet Trifdng Dai hoc Y Hi Ndi
Muc tieu: So sinh hieu qui cua Duratocin va oxytocin trong giai doan 3 cua chuyen da. Doi tUgng va phuang phap nghien ctfu: Cic sin phu de thddng tai Benh Vien Phu San Trung Udng. Thd nghiem lim sing ngiu nhien cd so sinh dddc thdc hien tai Benh Vien Phu San Trung Udng. Nhdm I: Cic sin phu sau khi liy thai den vai trddc thi tiem bip Duratocin 1ml mot lieu duy nhi't. Nhdm II: Theo ddi nhd nhdm I, sau khi thai ra den vai trudc tiem bip Wdv oxytocin. Kit qua: Lifdng miu mi't trung binh giai doan 3 d ca 2 nhdm li tuang td nhau (151,1 ± 78,7ml a nhdm 1 vi nhdm 2 li 138,6 ± 80,5ml; p = 0,57J. Tuy nhien, ty le KSTC d nhom I li 11,1%o, thi'p ban cd y nghTa thdng ke vdi p < 0,05 so vdi nhdm II cd cd ty le KSTC li 22,9%o.
Nhom tiem Duratocin cd Idang miu mi't trong 2 gid diu sau so rau 200 ± 113,1ml, trong khi dd Idang miu mi't trong 2 gid diu sau so rau d nhdm tiem oxytocin li 262,3 ± 162,2ml, sd khic biet niy cd y nghTa thd'ng ke vdi p < 0,05. Sd khic biet cd y nghTa thd'ng ke vdi p < 0,05 vi nhu ciu phai dung them thud'c tang co ca Id cung d nhdm 1 la 13,9%o vi nhdm 2 li 34,3%o. Kit luan: Trong giai doan 3 chuyin da., Duratocin vi oxytocin cd hieu qua nhd nhau trong viec lim rut ngin giai doan sd rau vi giam Idang miu mit. Duratocin lim giam nguy ca phai dung them thudc ting co cd td cung vi giam lifdng miu mi't trong 2 gid diu sau de so vdi oxytocin.
Td khoa: thuoc tang co, glal doan so rau
LDATVANDE
C h l y mau sau de la nguyen nhan hang dau gay tfl vong me tren the'gidi dae biet d cac nflde dang phat trien. Gan day bxytdcin da dflpc chflng minh la cd hieu q u i cao, lam g i l m 4 0 % ty le ehay mau sau de va dflpc sfl dung thfldng quy trong giai doan 3 eua chuyen da. Hien nay tren the' gidi ed sd dung Duratocin, mot chat ddng dang eua oxytocin, ed tac dung keo dai, vdi mpt l i l u duy nha't dflpc ehi djnh trong ngan ngfla ma't trflpng Ifle cp tfl eung va chay m l u sau de, lam g i l m Iflpng mau ml^t va ft can den cac bien p h l p k h i c vi nd duy tri, thdi gian eo bdp tfl cung den 120 phut.
Viee d i n h g i l , so s i n h hieu qua cua Duratocin vdi oxytocin thi chfla dflpc nghien cdu trong nflde d l cap den, vi the chdng tdi tien hanh nghien eflu de tai nham muc tieu: So sanh bieu qua cua Duratocin va oxytocin tiem tinh mach trong giai doan 3 cua chuyin da.
II. DOI TLfONG vA PHU'ONG
P H A PNGHIEN CL/U
1 . DO'I tUPng nghien cdu: nhflng san phu den de thfldng tai benh vien Phu San Trung Uong:
khoe manh khdng mac cac benh d p v l man tfnh. Tudi thai tfl 38 den het 42 tuan (tinh theo ngay d i u cua ky kinh cud'i). Mot thai, ngdi ehdm.
Khdng dung c i c thudc tang co ed tfl cung trong giai doan 1 va 2 cda ehuyen da.
2. Tieu chuan loai trCf
- S i n phu m i c cac benh cap va man tinh.
- S i n phu m l e benh v l s i n khoa nhfl rau t i l n dad, rau bong non, t i l n s i n giat, thieu d i . . .
- Thai ndn t h i n g (tudi thai dfld? 38 t u i n ) . - Da thai.
- Bl^t thfldng v l ngdi thai v l cac dj dang tfl cung. ' ,
- Tien sfl cd seo md cu d tfl eung: md lay thai, md bdc nhan xd,...
- Cd c h l y mau trflde d§.
- Thieu mau nang Hb dfldi 7g/l.
- Dung thudc tang co ed tfl cung giai doan 1 va 2 eua chuyen da.
3. PhUPng phap nghien cufu: nghien cflu thif nghiem lam sang n g l u nhien cd so s i n h . Mdi nhdm la'y 30 benh nhan. D i n h sd benh nhan n g l u nhien theo thfl tfl thdi gian nghien cflu theo sd chan le, sd le se nam d nhdm I, sd ehan roi vao nhdm 11.
- Nhdm I: C I c san phu sau khi lay thai den vai tnide thi tiem b l p duratocin 1 ml mpt lilu.duy nhat.
- Nhdm II: Theo ddi nhfl nhdm I, sau khi lay thai de'n vai trflde tiem lOdv oxytocin tiem b l p .
Thudc oxytocin 5dv/1ml eua hang Gedeon Riehter s i n xua't.
Duratocin cua hang Ferring, dng 1 ml chda 100 mc;g carbetoein.
4. Danh gia ke't qua
- Thdi gian giai doan 3: dflde tinh tfl sau khi thai sd den khi rau so hoan t o l n qua dfldng am dao ra ngoai.
- D i n h gia Ifldng m l u mat:
-I- Lflpng mau mi't trong giai ddan sd rau dfldc x l e djnh: gdm toan bp m l u tfl am dao c h l y ra XU sau khi thai sd de'n khi rau sd hoan t d i n ra ngoai am dao.
+ Lflpng mau ma't trdng 2 gid d i u sau sd rau dflpe xac dinh; gdm tdan bd mau tfl am dad ehay ra sau khi rau sd ra ngdai de'n 2 gid sau dd.
+ Tdng Ifldng m l u mat sau sd thai den 2 gid dau sau sd rau la lflpng mau mat trong giai doan sd rau cpng vdi Ifldng mau mat trdng 2 gid d i u sau dd.
4- Cach do Ifldng mau mat: Lflpng mau tfl I m dao ehay ra dflpe hflng vao tui nilon cd ehia vach
TCNCYH 71 (6J - 2010
ml. Mau cue dflpc can tfnh ra gam.
Quy ddi ra dpn vj the tich theo cdng thfle:
V = m/d
V: Ta thi tich miu mit (ddn vj ml); m: Ta khdi lifang miu mit (dan vj gam); d: khdi Iddng rieng ciia mau (d = 1,051).
CIc sd lieu thu thap dflpe dflpc xfl ly v l phan tieh tren m i y tfnh bang p h i n m l m SPSS 13.0 v l STATA 6.0 de tfnh t o l n e l e ty le, t i n suat, g i l tri trung binh, he sd tfldng quan.
Cie test kiem dinh dflpe sfl dung T - test, yj - test, chpn p < 0,05 dflpc coi la khac biet cd y nghTa thdng ke.
in.KETQUA
So'san phu sinh con so chiem ty le eao hon so vdi sinh eon ra. Khdng ed sfl k h i c biet cd y nghTa thdng ke v l so' lan de gifla 2 nhdm nghien cdu vdi p > 0 , 0 5 .
Sd sin phu cd Hb 90 - 109g/l chie'm t'y- Id eao 46,5% ehung eho e l 2 nhdm, ehu yeu la thieu mau nhifpe sic. Khdng ed sfl k h I e biet ed y nghTa thdng ke v l ty le thieu mau gifla 2 nhdm nghien eflu vdi p > 0,05.
Sd tre can nang 3000 - 3400g ehiem le eao nhat (50%) d nhdm I va ehiem 54,3% d nhdm II.
Ty le thai > 3500g d nhdm I IA 22,2% va d nhdm II 11 14,3%. Trpng Iflpng thai trung binh d nhdm I IA 3246g ± 820 g, trpng Ifldng thai trung binh d nhdm II la 3168 ± 740 g, khdng ed sfl khae biet ed y nghTa.thdng ke gifla 2 nhdm nghien cdli vdi p > 0,05.
Thdi gian giai doan 1 tinh tfl khi bat d i u chuyen da den khi cd tfl eung md het. Thdi gian giai doan 1 eua nhdm I IA 8,6 ± 4,5 gid, nhdm II I I 7,9 ± 5,4 gid khdng ed sfl khae biet cd y nghTa thdng ke vdi p > 0,05.
Giai doan 2 trung binh cua nhdm' 1 la 12,8 ± 13,7 phdt; nhdm 11 la 13,4 ± 10,7 phdt. Thdi gian giai doan 2 tfnh tfl khi cd td cung md het den khi thai sd hoan toan ra ngdai am dad d 2 nhdm khdng cd sfl khae biet cd y nghTa thdng ke vdi p > 0,05. •
Nhdm I tiem Duratocin thdi gian giai dean 3 trung binh la 5,1 ± 0,9 phut (dad dpng tfl 3 - 1 0 phut); nhdm II tiem b l p 10 dPn vi oxytocin, thdi gian giai doan 3 trung binh la 5,3 ± 2,2 phut (dao dpng tfl 2 - 1 5 phut). Thdi gian giai doan 3 tdc thdi gian sd rau la tfldng tfl nhau gifla 2 nhdm nghien eflu vdi p > 0,05.
Bang 1. Ltfgng mau mat trong 2 gid diu sau de
Nhom Nhdm 11 G I I trj p
Lflpng mau mat sau 2 gid trung binh 200 + 113,1 ml 267,3 ± 162,2 ml
M i n 30 0,046*
Max 595
Lifdng miu mit trong 2 gid dau sau de d nhdm I thip ban so vdi nhdm 11, sd khic biet niy cd y nghTa thdng ke vdl p < 0,05.
60 50 40 '- 30 '"
20 10 0
^ ' s
I
D< 300ml Isl301^99ml D> 500ml
Bieu doi. Lugng mau mat ttf sau khi so rau din 2h diu sau de
nhom 1 nhom 11
Bang 2. Phan bd ty le kiim soat ttf cung trong cac nhom nghien ctfu
Kiem soat tuf cung Nhom I Nhom 11
%
Gia trj p
Cd
Khong4 32
11,1 88,9
8 27
22,9
77,1 0,01
Tdng sd 36 100 35 100
Chi djnh kiem soat td cung khi cd ehay miu sau khi thai sd, hoae do sdt rau (phat hien bang kiem tra banh rau). Trong nhdm. I dung Duratocin ty le KSTC la 1 l,1%o thip hdn so vdl nhdm II dung Oxytocin (ty le KSTC la 22,9%o), sif.khac biet nay cd y nghTa thing ke vdi p < 0,05. Diiu nay cd nghTa la dddi tic dung Ciia thudc tang co thi Duratocin gidp rau sd du hdn, it chay mau han so vdi Oxytocin.
Bang 3. Nhu cau dung them thudc tang co ca ttf cung
Dijng them thudc tang co cP tuf cung
Nhom I Nhdm II
%
Gia trj p
Cd
Khdng5 31
13,9 86,1
12 23
34,3
65,7 0,04
Tdng so' 36 100 35 100
Tac dung khong mong mudn cua thudc Oxytocin va Duratocin: Khi nghien cdu tren 71 san phu chung tdi khdng thay mpt trfldng hpp nao xuat hien t i c dung phu eua thude.
IV. B A N LUAN
So vdi n h i l u tac g i l trflde day Hd Sy Hung [1].
(1999), Bui Thi Phfldng [2] (2001), N g u y i n Thi Thuy[3] (2005) thi trpng Ifldng thai trung binh trdng nghien eflu cua chdng tdi cao hdn. Dieu n l y p h i n anh chat Ifldng eupc sdng dflpe e i i thien va ngay eang dfldc nang cao. Tuy nhien trpng Iflpng thai tang len cung la mot nguy CP d i n den chay mau sau de. Theo Combs va Laros, trpng Iflpng thai tren 4000g lam tang nguy cP ehay m l u 2,5 lan [14]. Do dac diem eua chpn m l u , ddi tflpng nghien cflu eua chung tdi I I de thfldng nen khdng cd s i n phu nao de eon tren 4000g.
Trflde day khi dd de thfldng eae thay thude ed' g i n g gifl tang sinh mdn. Ngay nay eat TSM dflde ehi djnh rpng rai nham muc dfch tranh r i c h phfle tap va giup thai sd d l dang hpn. C h l y mau tfl vet
e l t TSM khdng nhieu neu cat dung thdi diem, dung ky thuat. Trong nghien eflu cua chung tdi, da sd e l e san phu ed eat TSM khi sd thai. Chi cd 2 san phu khdng cd e l t TSM khi thai sd chiem 2,8%
trong ea 2 nhdm nghien cdu. Khdng cd sfl khic biet ed y nghTa thd'ng ke v l ty le cat TSM gifla 2 nhdm nghien cdu vdi p > 0,05.
Quan diem ludn tdn trpng giai doan sinh ly cua sd rau, chi tien hanh dd rau khi rau da bong hoan toan. Vdi kieu sd- rau tfl nhien thi bong rau kieu mang chie'm ty le 7 5 % edn bong rau kieu mdi chie'm ty le 2 5 % . Bong rau kieu mang la kieu bong rau gpn ft chay mau cdn bong rau kieu mui d l gay sdt rau va mat mau nhieu hdn. Trong nghien cdu cua chdng tdi, bdng rau kieu mang ehiem da sd c i e trfldng hpp de, chie'm 88,9% d nhdm I, chie'm 8 0 % d nhdm II. Khdng cd sfl khic biet ed y nghia thdng -ke v l kieu bong rau gida 2 nhdm nghien eflu vdi p > 0,05.
Giai doan 1 la giai doan dai nha't cua eupc chuyen da, neu giai doan nay kee dai s i n phu met mdi, kem chiu dflng se ed jiguy cp de can
TCNCYH 71 (6J - 2010
thiep, dd tfl cung sau de. Theo Combs, Gilbert [6], giai doan 1 keo dai tren 1 2 gid lam tang ti le chay m l u sau de len 1,5 lan.
Thee nghien cdu cua chdng tdi, thdi gian giai doan 1 cua nhdm I la 8,6 ± 4,5 gid, nhdm II la 7,9
• ± 5,4 gid. Sfl khac biet gifla 2 nhdm khdng ed y nghTa thdng ke, ket q u i nay cung tfldng tfl nhfl eac t i c g i l Dfldng Thi Cfldng (1997), Hd ST Hung (1999) [1], Bui Thj Phfldng [2] (2000), N g u y i n Thi Thuy [3] (2005).
Giai doan 2 (giai doan sd thai) la giai doan I n h hfldng den tinh trang thai n h i l u nha't. Neu giai doan nay keo dai, nguy cP suy thai, de can thiep tang len lam tang nguy CP c h l y mau sau de.
Vi vay thdi gian nay g i l n tie'p anh hfldng de'n lifpng mau mat sau de.
Theo nghien cflu eua Combs va Gilbert, neu thdi gian ran de keo dai tren 45 phdt lam tang nguy ed c h l y mau len 1,8 l l n [6].
Theo nghien cflu cua ehung tdi thdi gian giai doan 2 trung binh eua nhdm 1 la 12,8 ± 13,7 phut; nhdm 11 la 13,4 ± 10,7 phdt. Sfl khac biet gifla 2 nhdm khdng ed y nghTa thdng ke.
Theo mpt sd t i e g i l khac: Dfldng Thj Cfldng (1997). thdi gian giai doan 2 la 14,4 ± 8,4 phut;
Hd ST Hung (1999) [1].: 1 8 , 9 ± 7,88 phdt; Bui Thj Phflong[2). (2000); 14,5 ± 5,8 phut; N g u y i n Thj Thuy [3]. (2005): 22,5 ± 6,3 phut; ket q u i cua ehung tdi cd thap hdn. Dieu nay ed le do ddi tflpng nghien cflu cua chdng tdi la ddi tflpng nguy ed thap thfldng dd d l dang khdng phai can thiep gi.
Giai doan 3 cua chuyen da (giai dean sd rau) Men quan de'n n h i l u bien chflng c h l y mau tai vung rau b i m . Ngay sau khi rau bcng tdan bp cae mach m l u vung rau bam se hd, khi tfl cung co that e l c CP dan cua tfl eung se that chat gay t i c mach sinh ly, ket hpp vdi e l c yeu td ddng m l u trong huyet tflpng, tieu c l u gidp cam mau sau de.
Trong nghien edu cda chung tdi, khi can thiep vao thdi diem ngay sau khi sd thai, nhdm I tiem Duratocin thdi gian giai doan 3 trung binh la 5,1 + 0,9 phut (dao dpng tfl 3 - 10 phut); nhdm 11 tiem bap 10 ddn vj dxytdcin, thdi gian giai doan 3 trung binh la 5,3 ± 2,2 phut (dao dpng td 2 - 1 5 phut). Sfl k h i c biet gifla 2 nhdm khdng ed y nghTa thdng ke.
Sd sanh vdi eac nghien cflu khac;
So sanh vdi ke't q u i nghien eflu eua Danserau J (1999) va Mohamad F (2008) [8]., Duratocin lam rut ngan thdi gian giai doan 3 mpt each ed y nghTa so vdi nhdm dung Oxytocin (p < 0,05). Cd the la do cd mau nghien edu eua ehung tdi nhd hdn, dd'i tfldng nghien eflu la s i n phu dd thfldng ft nguy cd nen du Carbetoein cd t i e dung rut ngan thdi gian giai dpan 3 nhflng sfl khac biet chfla ed y nghTa thd'ng ke.
Lflpng m l u mat trong giai doan 3 trung binh eua nhdm I (tiem Duratocin) la 151,1 ± 78,7 ml (dao dpng tfl 50 - 800 ml); nhdm II (tiem oxytocin) la 1 38,6 ± 80,5 ml (dao dpng tfl 50 - 450 ml); Sfl khae biet v l Iflpng m l u mat giai doan 3 gifla 2 nhdm khdng cd y nghTa thdng ke vdi p > 0,05;
Bang 4. Lugng, Nghien cdu
Boucher M (1998) [4] (n = 57) Boucher M (2004) [5] (n = 131) Mohamad F (2008) [8] (n = 720) Dang Thj Minh Nguyet (n = 71)
mau mat giai doan 3 Nhom 1 (ml)
159 ± 9 2 413 ± 197 355 ± 210 151 ± 7 8
so sanh vdi mgt sd tac Nhom II (ml)
1 8 8 ± 1 1 5 4 1 0 ± 194 390 ± 1 9 8
138 ± 8 0 gia
Gia trj p
> 0,05
> 0 , 0 5
< 0 , 0 5
> 0,05
Theo b i n g tren ta tha'y, trong nghien cdu eua Mdhamad F (2008) [8]. Duratocin lam g i l m Iflpng mau mat giai doan 3 mpt each cd y nghTa so vdi nhdm dung Oxytdcin (p.< 0,05). Ket qua nghien cdu eua chdng tdi phu hdp vdi nghien cflu eua Bducber M (1998) [4] va (2004) [5]. khdng cd sfl khae biet cd y nghTa thdng ke ve Ifldng m l u mat giai ddan 3 gifla 2 nhdm nghien cdu (p > 0,05). Sc vdi cae tae g i l khae, trcng nghien edu cua ehung tdi, Ifldng mau m i t giai ddan 3 thap hdn sd vdi cae nghien edu khac.
Theo djnh nghTa cua TCYTTG, chly" mau sau de khi- Iflpng mau mat tren 500ml thi ty Te ehay mau sau de d nhdm I la 1 1 , 1 % tha'p hon so vdi t'y" le c h l y m l u sau de d nhdm II la 1 7 , 1 % , tuy nhien sfl khac biet nay khdng cd y nghTa thdng ke vdi p > 0,05.
Nhu c l u phai dung them thud'c tang co cP tfl cung d nhdm 1 la 13,9% thap hpn so vdi nhdm II IA 34,3%, sfl k h i c biet nay cd y nghTa thdng ke vdi p < 0,05. Ket q u i nay tfldng tfl vdi ke't q u i cua e l e nghien eflu k h i c tren the gidi nhfl Bdueher M (1998 vA 2004), Danserau (1999), Attilakds (2008), Mohamad F (2008). [8L
V. KET LUAN
Qua nghien cflu 71 san phu de thifdng tai Benh vien Phu Sin Trung flong nham sc sanh hieu q u i eua Duratdcin va Oxytocin trong giai doan 3 eua chuyen da chung tdi rut ra mpt so' ket luan sau:
- Duratocin va oxytocin cd hieu qua nhfl nhau lam rut ngan giai doan sd rau va g i l m lflpng mau mat giai doan 3. Thdi gian giai doan 3 trung binh d nhdm tiem Duratocin la 5,1 phut, d nhdm tiem oxytocin la 5,3 phut. Lflpng mau mat giai doan 3 tmng binh d nhdm tiem Duratocin la 151,1 ± 78,7 ml va nhdm tiem Oxytocin la 1 38,6 ± 80,5 m l .
- Duratocin lam giam nguy cP phai dung them thude tang cd cd tfl eung va giam Ifldng mau mat trdng 2 gid d i u sau de sd vdi Oxytocin.
- Duratocin ed dp an toan tfldng tfl nhfl Oxytocin trong xfl tri tich cflc giai doan 3 eua chuyen da.
T A I LIEU THAM KHAO
1. Hd ST Hung (1999). Danh g i l hieu qua eua phfldng p h l p tiem oxytocin tTnh mach rdn len sfl sd rau, luan van tdt nghiep b i c sT ndi tm benh vien trfldng Dai hpe Y Ha N p i , 27 - 52.
2. Bui Thj PhUPng (2001). Nghien eflu t i c dung tiem oxytocin tTnh maeh me len giai doan sd rau, luan van thac sT Y hpe Trfldng Dai hpe Y Ha N p i .
3. Nguyen Thj Thuy (2005 ). So sanh hieu qua eua Misoprostol dfldng ud'ng va oxytocin tiem tTnh maeh trong giai doan 3 cua chuyen da, luan van tdt nghiep b l e sT ndi trd benh vien.
4. Boucher M (1998). Double - blind, randomized comparison of the effect of carbetoein and oxytocin on intraoperative blood loss and uterine tone of patients undergoing caesarean section. Journal of Perinatology; 18 (3): 202 - 7.
5. Boucher M (2004). Carbetoein IM injection vs dxytdcin IV infusidn fdr preventidn of postpartum haemorrhage in women at risk followingvaginal delivery. Journal of Obstetrics &
Gynaecology Canada; JOGC; 25 SuppI; SI 5.
6. Combs A.C, Laros K.R (1991). Prolonged third stage of labor: morbidity and risk factors, Bristish J Obstet Gynaecol, 77: 863 - 857.
7. Dansereau J (1999). Double - blind comparison of carbetoein vs oxytdcin in preventing uterine atony post cesarean section.
International Journal of Gyneeoldgy and Obstetrics 1999; 46 SuppI: 77.
8. Su LL, Chong VS, Samuel M (2008).
Oxytdcin agonists for preventing postpartum haemorrhage, the Cochrane Ccllabdratidn.
TCNCYH 71 (6J - 2010
Summary
COMPARISION BETWEEN THE EFFICACY OF DURATOCIN AND OXYTOCIN IN THE THIRD STAGE OF LABOUR
Objectives: To compare the efficacy of Duratocin to oxytocin in the third stage of labour. Methods:
Women undergoing vaginal delivery in National Obstetrics and Gynecology Hospital. A randomized controlled clinical trial was conducted in National Obstetrics and Gynecology Hospital..71 women undergoing. vaginal delivery were divided 2 groups to receive either a single dose of 100 meg intramuscular Duratocin (group 1, n = 36) or 10 lU intramuscular oxytocin (group 2, n = 35) at the birth of anterior shoulder of the fetus. Results: The mean blood loss of the third stage of labour was similar in two groups (151.1 ± 78.7 ml in group 1 versus 138.6 ± 80.5 ml in group 2, p = 0.51). However, group 1 having the ratio of uterus control is 1 1 , 1 % lower than 22.9% of group 2 and the mean blood loss in the first two hours after delivery in group 1 was significantly lower than those in group 2 (200 ± 113.1 ml vs 267 ± 162.2 ml, p < 0.05). The rate of additional uterotdnics administration in group 2 was higher than those in group 1 (34.3% vs 13.9%; p < 0.05). Conclusions: In the third stage of labour, Duratocin and oxytocin had the similar efficacy in shortening the placenta delivery duration and reducing blood loss.
However, Duratocin was shown to be more effective than oxytocin in reducing the need for additional uterotonics and in reducing the volume of blood loss in the first two hours after delivery.
Keywords: uterotonics, the placenta delivery
NGHIEN CLfu TAC DUNG CHONG VIEM CAP CUA CAO LONG THAN THONG TRUC L/ TREN T H U C NGHIEM
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Tran Thai Ha \ Nguyin Trong Thong ^ Nguyen NhUgic Klm^ Pham Thj Van Anh^
'Benh vien Y hoc cd truyin Trung Udng, '^Tnfdng Dai hoc Y Ha Noi Nghien cifu tic dung chdng viem cip cua cao Idng Thin thdng true if tren thdc nghiem. Muc tieu: Dinh gia tic diing chdng viem cap cua cao Idng Than thdng true d tren chudt cd'ng tring. Doi tugng va phuang phap nghien ctfu: Cao Idng Thin thdng true d ddOcdung d lieu 16g/kg vi 48g/kg chudt cdng (tdang ddang lieu dung tren lam sing vi gap 3 liiu lim sing) di nghien edu tic dung chdng viem cip tren thdc nghiem.
Kit qua: Cao Idng Thin thdng true d liiu thi'p 16g/kg khdng lam giam sd Iddng djch rl viem, so ldang''bach ciu vi him Idang protein trong djch rl viem, tuy nhien d liiu cao 48g/kg cd mot phan tic dung chd'ng viem thdng qua lam giam Idang dich. rl viem. Cao Idng Thin thdng tnjc d cd tic dung chdng viem cip tren md hinh giy phu chin chudt cd'ng bang carrageenin. Kit luan: Cao Idng Thin thdng true d cd tic dung chdng viem cap tren chudt cdng tring.
Tuf khoa: Than thdng true fl, chdng viem cap, chuot cdng tring
I. D A T V A N D E Vflong Thanh Nham, la bai thude dflpe sfl dung tfl Cao Idng Than thdng true 'fl ed ngudn gdc tfl lau ddi, nhflng nam g i n day dflpc danh gia cd bai thude ed phfldng "Than thdng true fl thang" hieu q u i eao trong dieu trj benh ly thoat vj dTa trieh tfl pho s i c h ed "Y lam e i i thae"eua tae g i l dem va flng dung rdng rai tai Trung Qudc [10).
