依沙吖啶与米非司酮配伍米索前列醇用于孕16～28周引产对比观察

lntraanmiotic ethacridine lactate instillation versus mifepristone and misoprostol combination in 16-28 weeks termination of pregnancy

目的对依沙吖啶（利凡诺）与米非司酮配伍米索前列醇用于孕16～28周引产进行对比观察。方法因各种原因自愿终止妊娠的孕16—28周患者100例，随机均分为两组：A组依沙吖啶100mg经腹羊膜腔内注射，B组清晨空腹口服米非司酮150mg，同时阴道后穹窿放置米索前列醇。观察两组患者胎盘及胎儿排除时间、阴道流血量、住院时问及引产效果等。结果A组完全引产率为76％（38／50）、清宫率为20％（10，50）、胎盘及胎儿排除时间为（42．0±5．8）h、住院时间为（96±6）h、阴道流血量为（110．6±6．5）ml，B组各指标分别为98％（49／50）、2％（1／50）、（12．5±4．5）h、（72±4）h、（46．3±5．6）ml，两组比较差异均有统计学意义（P〈0．05）。结论口服米非司酮配伍阴道用米索前列醇用于孕16～28周引产，与依沙吖啶羊膜腔内注射比较，胎盘及胎儿排除时间、住院时间短，阴道流血量少，成功率高，值得临床推广。

Objective To observe oral mifepristone and vaginal misoprostol combination （medical induction labor）for 16-28 weeks termination of pregnancy and compare the effectiveness with intraamniotic instillation ofethacridine lactate （EL） in this setting. Methods 16-28 weeks gestation, total 100 pregnant women from February 2006 to June 2007 were elected. Two groups were divided randomly： group A （intraanmiotic injection of ethacridine lactate）and group B（ mffepristone and misoprostol combination）. Main outcome measures： success rate, induction-delivery interval, intrapartum hemorrhage, length of stay complications. Results Termination of pregnancy was successful in 38 cases （76%）, induction-delivery interval was （42.0 ± 5.8 ） h, length of stay was （96 ±6） h and intrapartum hemorrhage was （ 110.6 ±6.5 ） ml in group A. The matched pair analysis revealed termination of pregnancy was successful in 49 cases （98%）, there were significantly shorter induction-delivery interval （ 12.5 ±4.5） h, length of stay （72 ±4） h and lower intrapartum hemorrhage （46.3 ±5.6 ）ml in group B （P 〈 0.05）. Conclusions Compared to intraamniotic instillation of ethacridine lactate, oral mifepristone and vaginal misoprostol combination for 16-28 weeks termination of pregnancy had higher successful rate, shorter induction-delivery interval, length of stay and lower intrapartum hemorrhage.