米非司酮联合羊膜腔穿刺注射利凡诺用于瘢痕子宫引产的临床研究

The clinical research of mifepristone combined with rivanol in the use of scar pregnancy

目的探讨米非司酮联合羊膜腔穿刺注射利凡诺引产在瘢痕子宫中期妊娠的临床治疗效果。方法选择2010年5月至2013年9月广东省河源市和平县妇幼保健院收治的90例中期妊娠、身体健康且自愿要求终止妊娠的瘢痕子宫患者,分为研究组(45例)与对照组(45例),研究组给予口服米非司酮并联合羊膜腔穿刺注射利凡诺,对照组单纯行羊膜腔内穿刺注射利凡诺,观察并记录两组注药至宫缩开始时间、宫缩至胎儿胎盘娩出时间、腹痛程度、产后2 h阴道出血量、产后出血持续时间以及引产并发症。结果研究组完全引产率(93.33%)明显高于对照组(66.67%),而引产成功率两组对比(100%vs 95.56%)差异具有统计学意义(χ2=7.26,P<0.03),研究组注药至宫缩开始时间(20.8±3.5 h),排胎时间(28.9±4.2 h),产后2 h阴道出血量(62.5±24.8 ml)以及产后出血持续时间(4.3±2.3 h)均明显少于对照组(30.9±6.5)h、(38.9±10.5)h、(94.6±36.8)ml、(7.7±3.3)d。两组对比差异均具有统计学意义(P<0.05),研究组无宫颈裂伤和子宫破裂对照组,宫颈裂伤和子宫破裂各1例,研究组疼痛情况明显好于对照组,两组对比差异均具有统计学意义(χ2=6.49,P<0.05)。结论米非司酮联合羊膜腔穿刺注射利凡诺在瘢痕子宫引产可有效缩短引产时间,增加引产成功率,增加手术的安全性和有效性,并降低不良反应发生率。

Objective To investigate the clinical effect of mifepristone combined with rivanol in the use of scar pregnancy. Methods Women with mid-trimester of pregnancy admitted from May 2010 toSeptember 2013 were randomly divided into control group(induced labor by rivanol, n=45) and research group(induced labor mifepristone combined with rivanol, n=45). The time from drug injection to the contractionsstart, the delivery time, the degree of abdominal pain, the 2 h postpartum vaginal haemorrhage amount,postpartum bleeding duration and induced labor complications were compared. Results The completelyinduced labor rate of research group is significantly higher than that of the control group, and the difference ofthe success rate of induced labor between two groups was statistically significant(P<0.05), The time from druginjection to the contractions start, the delivery time, the 2 h postpartum vaginal haemorrhage amount,postpartum bleeding duration and induced labor complications of research group is significantly lower than thatof the control group, the incidence of cervical laceration and Uterine rupture of the research group aresignificantly lower than the control group, the degree of abdominal pain is less than the control group, thesedifferences show statistical differences(P<0.05). Conclusions Mifepristone combined with rivanol couldeffectively shorten the time and increase the success rate of induced labor, increase the safety and efficacy ofsurgery, and reduce the incidence of adverse reaction in the scar pregnanc. Combined amniotic cavity puncturemifepristone rivanol induced labor in scar uterus induced labor can effectively shorten the time and increasethe success rate of induced labor, s.