Comparison Of Several Inhibitors Of Uterine Contraction In The Treatment Of Threatened Premature Labor

Background and ObjectivePremature birth in medicine is mainly refers to pregnant women in pregnancy is less than 37 weeks and more than 28 weeks, the fetus in the stage of the development is not mature, will lead to a higher incidence of premature infants, easy to cause respiratory diseases such as respiratory distress, and even death. Therefore, the relevant doctors or researchers should attach great importance to the prevention and treatment of premature birth.Ritodrine hydrochloride in the treatment of threatened premature delivery key one of the drugs, from a certain degree, is a highly selective neural drug, in oral, intravenous note and intramuscular injection treatment have good therapeutic effect. The location of the effect is the uterine muscle layer, which can be used in combination with a receptor on the cell membrane of the uterine smooth muscle,thereby activating the adenosine cyclase, and directly improving concentration of adenosine in cells, reducing the concentration of calcium in the cells.To inhibit the uterine contraction of pregnant women to play an important role, can effectively extend the gestational age of pregnant women with threatened premature delivery. In addition, ritodrine hydrochloride can be in a certain extent by improving the blood circulation of the placenta and contribute to Fetal development. On the basis of ritodrine hydrochloride treatment condition, effect of ritodrine hydrochloride therapy has better therapeutic effect than Magnesium sulfate, and the risk of adverse reactions is lower than that of magnesium sulfate.This study selected women with threatened premature delivery clinical respectively, and the application of ritodrine hydrochloride, magnesium sulfate, indomethacin and nifedipine treatment, through to several drugs clinical effect observation and analysis, explore the drug for clinical curative effect in the treatment of threatened premature delivery, to provide theoretical guidance for clinical application.Research methods1. In this study, a total of 160 cases of threatened premature labor patients in our hospital from August 2013 to 2014 October. All patients appear abdominal distension, vaginal appeared bloody secretions and contraction phenomenon, in line with the criteria for the diagnosis of threatened premature labor. The routine examination, blood routine, blood sugar, blood glucose, thyroid examination and liver and kidney functions were normal. Randomly divided into group A and group B, group C and group D four groups, A group of 40 patients, aged between 22 and 35, the average age was (27.11 ± 2.92); Gestational age in 28-35 weeks, the average week gestational age (32.26 ± 2.15); Between 60 and 76 kg weight, average weight (64.23±5.18) kg; The first-timer 23 cases patients,17 cases of the patients; B group of 40 cases, between the ages of 21 and 37, the average age was (29.01±3.53); Gestational age in 29-36 weeks, the average week gestational age (32.7±1.7); Between 59-73 kg weight, average weight (65.27± 3.27) kg; The first-timer patients 21 cases,19 cases of the patients. Group C (n= 40), age 22-36 years old, the average age for (27.24±2.90) years. Gestational age at 28-36 weeks, mean gestational age (32.36±2.05) weeks; weight between the 61-77kg, average weight (65.23 ± 5.07) kg, including 24 cases of primiparous patients, multiparous patients 16 cases. D group 40 cases, age between the ages of Lu 21-37, average age for (29.01±3.53) years old; gestational weeks at 29-36 weeks, mean gestational age (32.7±1.7) weeks; weight between the 58-72kg, average body weight (65.28±3.07) kg; primiparous 23 cases of patients, multiparous patients 17 cases. Four groups of patients in age, mean gestational age, birth weight and maternal time aspects such as general information does not exist significant difference (P> 0.05), and there are comparable. Interval for all patients with aura premature oxygen, premature rupture of membranes of pregnant women to give its broad-spectrum antibiotics to control, less than 34 weeks of gestation is pregnant women to give its dexamethasone oral treatment to promote fetal lung maturity. A group on the basis of routine treatment with 100ml of ritodrine hydrochloride and 5 percent glucose solution 500ml intravenous drip, beginning will drop speed control in 5 drops per minute, after every 10 minutes add 5 drops, in accordance with the infusion rate of maternal uterine actual situation appropriate adjustments to the intravenous injection of.General maintenance in 15-35 drops/min, and the intravenous drip of time until after a complete cessation of contractions 12-18h and above. The Every 4 h for pregnant women to a blood pressure measurement, measurement of heart rate and fetal heart measurement, the intravenous drip for half an hour before the end, changed to oral ritodrine hydrochloride tablet in the treatment. Group B on the basis of routine treatment, given the 16 ml of twenty-five percent magnesium sulfate and five percent glucose injection 20 ml of tardy intravenous drip, and to keep intravenous drip speed within 1 to 2 g/h. Group C patients in the conventional treatment under the premise taking indomethacin treatment and indomethacin starting dose for each taking 25 mg, and daily doses of two to three times between and in after a meal or dinner taking, can effectively reduce the medication after the gastrointestinal adverse reaction. Given D group patients in the conventional treatment under the premise of implementation of nifedipine in the treatment and doses of nifedipine for every 10～20mg and 2 times a day. If the four groups of pregnant women in the condition of repeated, can be repeated use.2.observation items and indicators (1) clinical effect:the clinical effect of the four groups were observed, the efficacy of the standard as follows:markedly effective for the treatment of uterine contraction symptoms were effectively controlled; effective for 48 hours after the delivery of pregnant women; invalid for the treatment of pregnant women with no obvious changes in symptoms. (2) in pregnant women with various adverse reactions:nausea, palpitation, vomiting in pregnant women.3.statistical method using SPSS 18.0 software was used for statistical analysis, count data using chi square test, P< 0.05 showed statistically significant.Results1.Four after treatment, the four groups had significant changes in the treatment effect, the A group was 95%, the effective rate of B group was 80%, the effective rate was 77.5% in C group,82.5% in D group, the total effective rate in A group was significantly higher than that in B group, C group, D group (P<0.05), with statistical significance. Four the adverse reaction of the2.groups in the treatment of pregnant women after treatment, the incidence of adverse reactions was 5%, the incidence of adverse reactions in group B was 20%, the incidence of adverse reactions in group C was 17.5%, the incidence of adverse reactions in D group was 12.5%, the incidence of adverse reactions in A group was significantly lower than that in B group, C group, D group (P<0.05), with statistical significance.Conclusion:1. after ritodrine hydrochloride after treatment, patients with threatened preterm labor symptoms improved markedly. Can effectively inhibit the contractions, pregnant women, patients with uterine disappear time was significantly shortened (P< 0.05), the duration of gestation (P< 0.05) and was statistically significant.2. after ritodrine hydrochloride therapy and prolong the time of pregnancy, thus increasing the neonatal birth weight, improve the perinatal survival rate (P< 0.05). There was significant.3. after ritodrine hydrochloride therapy, patients with adverse reaction rate was significantly lower (P< 0.05). As a result, it is statistically significant.4. Pregnant women with placenta previa or peeling, you cannot use of ritodrine hydrochloride treatment, before the use of drugs in the treatment of ritodrine hydrochloride, first of all to routine ECG examination and fetal heart examination monitoring of patients in drug use the start stage, need to use the lowest dose, timely observation of adverse reactions in the course of medication.