地诺前列酮栓在非胰岛素治疗的妊娠期糖尿病足月妊娠引产中临床分析

Clinical analysis on dinoprostone suppositories used for induced labor of full-term pregnancy of cases with gestational diabetes mellitus and without insulin treatment

目的:探讨地诺前列酮(欣普贝生)用于非胰岛素治疗的足月妊娠期糖尿病引产的有效性及安全性。方法:选择有引产指征的非胰岛素治疗的足月妊娠期糖尿病孕妇79例,其中欣普贝生组48例,对照组(催产素组)31例,比较两组的引产效果及分娩情况。结果:实验组促宫颈成熟率为93.75%,对照组为48.39%,实验组用药至临产时间、总产程均短于对照组,剖宫产率低于对照组,差异有统计学意义(P<0.01),实验组在产后出血、胎儿窘迫、分娩期血糖变化方面与对照组差异无统计学意义。结论:非胰岛素治疗的妊娠期糖尿病足月妊娠应用地诺前列酮栓引产与催产素相比成功率高、产程短,可提高阴道分娩率,降低剖宫产率,是安全有效的引产方式,值得临床推广。

[Abstract] Objective： To explore the effectiveness and safety of dinoprostone suppositories used for induced labor of full - term pregnancy of cases with gestational diabetes mellitus （ GDM ） and without insulin treatment. Methods： A total of 79 full - term pregnant women with GDM and the indications of induced labor and without insulin treatment were selected, including 48 cases in experimental group （ dinoprestone suppositories group） and 31 cases in control group （ oxytocin group） ; the effects of induced labor and delivery conditions in the two groups were compared. Results： The rates of cervical ripening in experimental group and control group were 93.75% and 48.39 %, respectively; the interval time from drug therapy to parturiency and the total stage of labor in experimental group were shorter than those in control group, the rate of cesarean section in experimental group was lower than that in control group, there was statistically significant differ- ence （ P 〈 0.01 ） ; there was no statistically significant difference in the incidences of postpartum hemorrhage and fetal distress, the changes of blood glucose during delivery period between the two groups. Conclusion ： Compared with oxytocin, dinoprostone suppositories used for in- duced labor of full - term pregnancy of cases with GDM and without insulin treatment had the advantages of high successful rate and short sta- ges of labor, which can improve the rate of vaginal delivery and reduce the rate of cesarean section, and the method is safe and effective for induced labor, and it is worthy to be popularized in clinic.