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[摘要]
目的 探讨乳酸依沙吖啶注射液联合米非司酮片和米索前列醇片治疗中期妊娠引产的临床疗效。方法 选取2013年9月—2017年3月安阳市人民医院妇产科收治的中期妊娠引产患者132例为研究对象,将所有患者分为依沙吖啶组(A组,44例)、米非司酮联合米索前列醇组(B组,41例)和依沙吖啶联合米非司酮和米索前列醇组(C组,47例)。A组腹部注射位点采用腰穿针行羊膜腔穿刺,注入乳酸依沙吖啶注射液100 mg。B组口服米非司酮片,50 mg/次,2次/d,连续3 d,第4天阴道后穹窿放置米索前列醇片0.4 mg。C组口服米非司酮片100 mg/次,1 h后采用腰穿针行羊膜腔穿刺,注入乳酸依沙吖啶注射液100 mg,12 h后阴道后穹窿放置米索前列醇片0.4 mg。观察各组患者的引产效果,比较术中及术后情况。结果 3组引产成功率比较差异无统计学意义。A、B、C组清宫率分别为36.36%、29.27%、12.77%,C组清宫率明显低于A、B组,3组比较差异具有统计学意义(P<0.05)。C组用药至宫缩时间、引产时间、产后2 h出血量、产后出血天数、胎盘残留率显著低于A、B组,3组比较差异具有统计学意义(P<0.05)。C组1级疼痛程度明显高于A、B组,3、4级疼痛程度明显低于A、B组,3组比较差异具有统计学意义(P<0.05)。3组患者复潮时间、经期持续时间相当,没有统计学差异。结论 乳酸依沙吖啶注射液联合米非司酮片和米索前列醇片治疗中期妊娠引产具有较好的临床效果,可降低清宫率和胎盘残留率,缩短用药至宫缩时间、引产时间,减少出现量和出血天数,具有一定临床推广应用价值。
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[Abstract]
Objective To evaluate the clinical effect of Ethacridine Lactate Injection combined with Mifepristone Tablets and Misoprostol Tablets in treatment of midterm pregnancy induced labor. Methods Patients (132 cases) with midterm pregnancy induced labor in Anyang People's Hospital from September 2013 to March 2017 were divided into ethacridine group (A group, 44 cases), mifepristone combined with misoprostol group (B group, 41 cases), and ethacridine combined with mifepristone and misoprostol group (C group, 47 cases). Patients in A group were lumbar puncture needle underwent amniocentesis in abdominal injection site, and be injected Ethacridine Lactate Injection 100 mg. Patients in B group were po administered with Mifepristone Tablets, 50 mg/time, twice daily, and continuously treated for 3 d. At 4th day, Misoprostol Tablets 0.4 mg were placed on the posterior fornix vagina. Patients in C group were po administered with Mifepristone Tablets 100 mg/time, then injected Ethacridine Lactate Injection 100 mg, and placed with Misoprostol Tablets 0.4 mg on the posterior fornix vagina after 12 h. After treatment, labor induction were evaluated, and intraoperative and postoperative conditions in three groups were compared. Results There were no significant differences in success rate of induced labor among three groups. The curettage rates in A, B, and C groups were 36.36%, 29.27% and 12.77%, respectively, and the curettage rates in C group were significantly lower than that in A and B groups, and there was difference among three groups (P < 0.05). The time of drug use to uterine contraction, time of induced labor, 2 h postpartum hemorrhage, the number of bleeding days, and placental residual rate in C group were significantly lower than those in A and B groups, and there was difference among three groups (P < 0.05). The grade 1 of pain degree in C group was significantly higher than those in A and B groups, but the grade 3 and 4 of pain degree in C group was significantly lower than those in A and B groups, and there was difference among three groups (P < 0.05). Conclusion Ethacridine Lactate Injection combined with Mifepristone Tablets and Misoprostol Tablets has clinical curative effect in treatment of midterm pregnancy induced labor, can decrease the curettage rate and placental residual rate, shorten the time of drug use to uterine contraction and time of induced labor, reduce the amount of appearance and the number of bleeding days, which has a certain clinical application value.
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