| Objective:⑴The purpose to explore the best mode of administration,and the doseof oxytocin during cesarean section,in order to reduce the occurrence of postpartumhemorrhage.⑵To investigate the function of oxytocin on hepaticischemia/reperfusion(I/R) injury caused by postpartum hemorrhage induce shock andvolume resuscitation.Methods:⑴305pregnant women who Select the cesarean section in our hospitalFrom January2012to October2012, were randomly divided into three groupsdepending on the type of method of use of oxytocin in surgery.Group A (98cases) foruterine injection group, Uterine intramuscular injection of oxytocin20U When the babyis delivered; Group B (105cases) for intravenous infusion group, after the baby isdelivered oxytocin20U rapid intravenous infusion of Ringer’s solution500ml; Group C(102cases) for intravenous infusion plus intravenous group,20U oxytocin infusion in500mL of Ringer’s solution and additional intravenous10U oxytocin bolus. Observethe placenta spontaneous separation time, the amount of bleeding during intraoperativeand postoperative, the incidence of postpartum hemorrhage and adverse reactions, thedifference of hemoglobin between the preoperative and postoperative, as well asmaternal blood pressure, heart rate changes before and after treatment.⑵24Sprague–Dawley full-term rats were randomly divided into3groups of Sham shockgroup (S), ischemia/reperfusion(I/R) and oxytocin treatment(OT) with8rats each.The model of postpartum hemorrhagic shock in rats was produced by uterine-incisiondelivery and femoral artery bleeding under anesthesia. OT group were administeredintraperitoneally either OT (1U/500g) or saline at10min before postpartum hemorrhagicshock and reperfusion and0、30、60、120min after reperfusion;I/R group wereintraperitoneal injection of saline at the same time point; S group merely received uterine-incision delivery.After shock30min the rats were treated by volumeresuscitation,All the rats were sacrificed at6h after reperfusion, and liver tissues andblood samples were collected. The contents of alanine aminotransferase（ALT）,aspartate aminoltransferase（AST）, tumor necrosis factor-α（TNF-α）in serum, and themalondialdehyde（MDA）, superoxidase dismutase（SOD）, myeloperoxidase（MPO）in liver were also determined.Results:⑴C ompared with group A、group B，group C had the highest rate ofPlacental natural peeling and need the shortest time, the least bleeding volume duringintraoperative and postoperative and the least decrease in postoperative hemoglobin（P<0.01）⑵D ifferent usesof oxytocin on maternal blood pressure, heart rate changeshave little effect, maternal application oxytocin after the occurrence of adverse reactionswas no obvious difference (P>0.05).⑶group I/R, serum TNF-a levels weresignificantly increased when compared to S groups(p<0.05), while OT treatmentabolished the I/R-induced elevation in this proimflammatory cytokine (p<0.05). SerumAST and ALT levels were markedly increase in the saline-treated I/R group,(p<0.05).However,the elevations in both AST and ALT levels in the OT-treated group weredepressed obviously (p<0.05),but still higher than S groups(p<0.05).⑷I/R injury insaline-treated and OT-treated rats led to increase hepatic MDA levels, MPO activitiesand depressed SOD activities and reached statistical significance when compared withsham-operated group (p<0.05). On the other hand, treatment with OT can preventeIschemia-reperfusion induced increase in hepatic MPO activity and MDA levels,butSOD activities obviously higher than group I/R(p<0.05).Conclusion:⑴In Cesarean section, after the baby is delivered immediately given20U oxytocin intravenous and10U oxytocin infusion, the placenta can quickly peel,reduce postoperative bleeding,effectively,and without increasing adverse drugreaction,and maternal hemodynamic effects, So this method is safe and effective,clinical worthy of promotion.⑵T he results of the present study show that OT hasprotective effects against oxidative hepatic injury and this protection involves theinhibition of neutrophil migration and the blockade of the release of proinflammatorycytokines. Oxytocin has protective effect may be connected with it can reduce lipidperoxidation damage and eliminate oxygen free radical. |
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