不同引产方法对中孕的引产效果比较

COMPARISON OF THE EFFECT OF DIFFERENT METHODS TO TERMINATE MIDTRIMESTER PREGNANCY

目的 探讨不同中孕引产方法临床应用的安全性和有效性。方法 将210例有引产指征的中孕初产妇随机分为4组，A组（n=50）口服米非司酮配伍米索前列醇引产，B组（n=50）口服米非司酮、宫颈内插入导尿管并配伍口服米索前列醇引产，C组（n=50）经阴道羊膜腔内注射利凡诺引产，D组（n=60）经导尿管羊膜腔外注射利凡诺配伍口服米索前列醇引产。观察4组病人引产时间、产后24h出血量、清宫术中胎盘胎膜残留量、住院时间，并进行比较分析。结果 B组引产成功率最高，其次为D组、A组、C组，差异有显著性（χ^2=7．635～20．152，P〈0．05）；引产时间和住院时间D组最短，B组次之，各组之间比较，差异有显著性（F=6．92、9．64，P〈0．05）；胎盘残留率4组无显著性差异（χ^2=2．521，P〉0．05）；产后24h出血量4组差异无显著意义（F=2．25，P〉0．05）。结论 口服米非司酮加用宫颈内插入导尿管配伍口服米索前列醇，以及经导尿管羊膜腔外注射利凡诺配伍口服米索前列醇引产两种方法用于中孕引产成功率高、引产时间和住院时间短，值得推广应用。

Objective To compare the safety and efficacy of four induced-labor methods applied in the midtrimester pregnancy. Methods Women receiving induced-labor termination in the midtrimester pregnancy were randomly divided into four groups： group A （n=50） given mifepristone combined with misoprostol; group B （n=50） given mifepristone and misoprostol combined with induction labor by insertion of meatus into cervix; group C （n=50） given intra-amniotic injection of rivanolum; group D （n=60） given extra-amniotic injection of rivanolum combined with misoprostol. The labor time, amount of bleeding in 24 hours and rate of remaining placenta were noted respectively. Results The effective rate of induced labor of group B was higher than that of groups D, A and C （χ^2=7. 635-20. 152,P〈0. 05 ）. The time of labor and hospitalization of patients in group D were shortest, compared with those of groups B, C and A （F=6.92,9.64;P〈0.05）. Conclusion Mifepristone and misoprostol combined with induction labor by insertion of meatus into cervix and extra-amniotic injection of rivanolum combined with misoprostol are two safer and more effective methods in termination of midtrimester pregnancy, and are highly recommended clinically.