米索前列醇配伍依沙吖啶用于中期妊娠引产的临床观察

Clinical research on Misoprostol combined with Ethacridine in induction of labor in second-trimester pregnancy

目的研究并验证小剂量米索前列醇配伍依沙吖啶终止中期妊娠效果,寻求一种安全有效,能明显缩短产程的引产方法。方法根据随机数字表将160例孕14～27周需要引产的健康孕妇随机等分为两组。研究组80例,先按常规行羊膜腔穿刺注入依沙吖啶100mg,术毕即于阴道后穹窿处放置米索前列醇50μg;对照组80例,只常规行羊膜腔穿刺注入依沙吖啶100mg。结果研究组单次引产成功率(93.8%)高于对照组(77.5%),差异有显著性(P<0.05);研究组胎儿排出时间为(35.2±10.2)h,短于对照组的(47.5±12.5)h,两组比较,差异有显著性(P<0.01);研究组宫颈裂伤率(2.5%)低于对照组(11.3%),差异有显著性(P<0.05);与对照组相比,研究组产后出血量、胎盘排出,均未受明显影响,不增加各种并发症和不良反应的发生率。结论米索前列醇配伍依沙吖啶引产明显提高了单次引产的成功率,大大缩短引产所需的时间,同时降低了宫颈裂伤率。因此只要严格掌握适应证,这是一种安全、高效、廉价、方便的引产方法,值得推广。

Objective To study the effects of low dose misoprostol combined with ethacridine in induction of labor in second - trimester pregnancy. Methods 160 cases with 14 - 27 gestational weeks desiring to be induction of labor were randomly divided into study group and control group. 80 cases in study group were injected 100 mg ethacridine into the amniotic cavity routinely and then 50 μg misoprostol was placed into the vaginal fornix after the injection; While 80 cases in control group were injected 100 mg Ethacridine into the amniotic cavity routinely. Results There was significant difference on successful rate of single induced labor（93.8% vs 77.5%, P 〈0.05） and fetal delivery time[ （35.2 ± 10.2） h vs （47.5 ± 12.5） h, P 〈0.01 ] between two groups. The cervical laceration rates of study group（2.5% ） was significant difference to that of control group（ 11.3% ）. There was no signifi- cant difference in placenta delivery time and postpartum hemorrhage between two groups. Conclusion It could increase the successful rate and reduce induction time of single induced labor by taken misoprostol combining with ethacridine. Also it can reduce cervical laceration rates in addition. It was a safe, reliable and high effective induced method for selected cases properly.