目的 探讨依沙吖啶联合米非司酮在中期妊娠引产治疗中的临床疗效。方法 选取郑州大学第三附属医院2015年1月-2019年6月产科220例中期妊娠引产患者为研究对象。根据治疗方法将患者分为对照组（80例）和观察组（140例）。对照组先口服米非司酮片，50 mg/次，2次/d，连续服用2 d后将米索前列醇片置于阴道穹窿处，妊娠24周以内400 μg/次，3 h重复，但不超过1.8 mg；妊娠24周以上200 μg/次，6 h可重复，每日给药不超过4次。观察组患者口服米非司酮片（用法同对照组）后1 h采用7号穿刺针于下腹正中、宫底下两三横指下方腹中线上进行羊膜腔穿刺，注入100 mg乳酸依沙吖啶注射液。比较两组患者的引产效果、手术情况、疼痛程度、月经恢复以及不良反应发生情况。结果 治疗后，观察组患者引产成功率与清宫率分别为98.57%与19.29%，对照组患者引产成功率与清宫率分别为85.00%与35.00%，两组比较存在统计学差异（P<0.05）。与对照组相比，观察组患者的产后2 h出血量、用药至规律宫缩时间、规律宫缩至胎儿娩出时间、产后出血时间及胎盘残留率更少（P<0.05）。治疗后，观察组患者1分疼痛的比率显著高于对照组（P<0.05）。两组患者月经复潮时间及经期持续时间比较无统计学差异。治疗期间，观察组和对照组不良反应发生率分别为8.57%、17.50%，两组比较无统计学差异。结论 依沙吖啶联合米非司酮可有效提高引产效果，引产时间短，产后恢复快，安全性高，在中期妊娠引产患者中具有较高的应用价值。

Objective To investigate the efficacy of ethacridine combined with mifepristone in treatment of midtrimester induction of labor. Methods Patients (220 cases) with midtrimester induction of labor in the Third Affiliated Hospital of Zhengzhou University from January 2015 to June 2019 were divided into control group (n=80) and observation group (n=140) according to the treatment method. Patients in the control group was po administered with Mifepristone Tablets, 50 mg/time, twice daily. After continuous administration of Mifepristone Tablets for 2 days, Misoprostol Tablets were placed on the vaginal fornix. Patients within 24 weeks of pregnancy were treated for 400 μg/time, 3 hours of repetition, but not more than 1.8 mg, Patients more than 24 weeks of pregnancy were 200 μg/time for 6 hours of repetition, no more than four times daily. Patients in the observation group were po administered with Mifepristone Tablets (the same as the control group). After1 hour of oral administration, amniocentesis was performed with no. 7 needle in the middle of the lower abdomen and the abdominal midline below the two or three fingers of the uterus, and injected with 100 mg Ethacridine Lactate Injection. The induced labor effect, operation condition, pain severity, menstrual recovery, and adverse reactions in two groups were compared. Results After treatment, the success rate of induced labor and the rate of curettage were 98.57% and 19.29% in the observation group, and 85.00% and 35.00% in the control group, respectively, there was statistical difference between the two groups (P<0.05). Compared with the control group, patients in the observation group had less bleeding volume in 2 h after delivery, the time from administration to regular uterine contraction, time from regular uterine contraction to fetal delivery, time of postpartum hemorrhage, and placenta residual rate (P<0.05). After treatment, the rate of 1 point pain in the observation group was significantly higher than that in the control group (P<0.05). There was no significant difference in the menstruation time and duration of menarche between two groups. During the treatment, the incidence of adverse reactions in the observation group and the control group were 8.57% and 17.50% respectively, there was no statistical difference between two groups. Conclusion Ethacridine combined with mifepristone can effectively improve the effect of induced labor, with short induced labor time, rapid recovery after childbirth, high safety, and high application value in the patients with midtrimester induction of labor.

R984

河南省医学科技攻关计划项目（201403110）