依沙吖啶及其联合方案在中期妊娠引产中的应用

The application of ethacridine and its combination regimen in inducing labor in the second trimester

目的探讨依沙吖啶及其联合方案在中期妊娠引产过程中的影响因素、疗效和并发症的发生情况。方法回顾性分析2015年1月1日至2019年12月31日自愿于我院妇产科进行中期妊娠引产的388例患者临床资料,根据不同的引产方式分为单一方案(依沙吖啶)组(252例)和联合方案(依沙吖啶+米非司酮或米索前列醇)组(136例),比较两种方案患者的基本情况、临床疗效、产程合并症和并发症等。结果联合方案与单一方案比较,有剖宫产史者(26.47%vs 17.01%)、体外受精-胚胎移植(7.35%vs 1.98%)、多胎妊娠(8.82%vs 3.57%)、因胎儿异常引产(75.74%vs 62.70%)及胎盘异常(16.9%vs 9.1%),两组差异均具有统计学意义(P均<0.05)。用药至规律宫缩的时间和引产时间单一方案组均较联合方案组长,分别为(33.59±11.11)h vs(31.17±9.81)h,(11.57±10.91)h vs(8.18±7.86)h,差异均有统计学意义(P<0.05),引产成功率、清宫率、产后出血量、产后发热及子宫破裂等两组间差异没有统计学意义(P>0.05)。结论孕产妇有剖宫产史、体外受精-胚胎移植、多胎妊娠和胎盘异常等情况,推荐选择联合方案引产。联合方案可有效缩短引产时间,降低产后并发症,有利患者身心健康。

Objective To investigate the influencing factors,efficacy and complications of ethacridine and its combination regimen during induction of labor in the second trimester.Methods A retrospective analysis was performed on the clinical data of 388 patients,who voluntarily underwent mid-pregnancy induced labor in the department of Obstetrics and Gynecology of our hospital from January 1,2015 to December 31,2019.According to different methods of induction,they were divided into single ethacridine group(252 cases)and combined ethacridine-mifepristone or misoprostol group(136 cases).Basic conditions,clinical efficacy,comorbidities and complications were compared in the two groups.Results Compare in two different group,there were significant differences in history of cesarean section(26.47%vs 17.01%),in vitro fertilization-embryo transfer(IVF-ET)(7.35%vs 1.98%),multiple pregnancy(8.82%vs 3.57%),induction of labor due to fetal abnormalities(75.74%vs 62.70%),and the proportion of placental abnormalities(16.9%vs 9.1%).The time from medication to regular contractions(33.59±11.11)h vs(31.17±9.81)h and labor induction(11.57±10.91)h vs(8.18±7.86)h were significantly longer in a single group compared with combined group(P<0.05).However,the success rate of labor induction,uterine clearance rate,postpartum hemorrhage,postpartum fever and uterine rupture were not significantly(P>0.05).Conclusion Pregnant women with a history of cesarean section,in vitro fertilization-embryo transfer,multiple pregnancy and placental abnormalities are recommended to choose the combined method for induction of labor.The combined method can effectively shorten the time of induced labor,reduce postpartum complications,and benefit the physical and mental health of patients.