地诺前列醇栓用于足月胎膜早破促宫颈成熟的临床研究

The clinical study on dinoprostone in premature rupture

目的探讨地诺前列醇栓用于足月胎膜早破促进宫颈成熟的临床疗效。方法对42例足月胎膜早破孕妇随机分为地诺前列醇栓组及缩宫素组各21例，地诺前列醇栓组采取地诺前列醇栓阴道后穹窿放药引产，缩宫素组静脉滴注缩宫素引产，观察两组引产所需时间、用药后6h、12h宫颈Bishop评分、药物起效时间、产程情况及其围产儿情况、妊娠结局等指标。结果地诺前列醇栓组用药到临产时间、用药到宫颈口开全时间分别为（6．18±4．48）h、（12．62±8．03）h，短于缩宫素组的（10．21±5．42）h、（18．87±9．14）h（t=2．62、2．35，均P〈0．05）；用药后6h、12h地诺前列醇栓组评分为（7．52±2．44）分、（9．03±1．96）分，优于缩宫素组的（5．97±1．95）分、（7．13±2．12）分（t=2．27、3．02，均P〈0．05）；地诺前列醇栓组潜伏期平均（9．91±1．73）h大于缩宫素组（8．72±1．34）h，活跃期（4．36±0．66）h小于缩宫素组（5．84±1．02）h，两组差异均有统计学意义（t：2．49、5．58，均P〈0．05）；两组第二产程时问、第三产程时间、胎儿宫内窘迫、羊水污染、剖宫产、新生儿Apgar评分等差异均无统计学意义（均P〉0．05）。结论地诺前列醇栓用于足月胎膜早破孕妇可促进宫颈成熟，效果优于缩宫素，且用药安全性较高。

Objective To explore clinical effect of dinoprostone in premature rupture of the membranes at term cervical ripening. Methods 42 cases with premature rupture of the membranes at term cervical ripening were selected. All patients were randomly divided into two groups. The dinoprostone group had 21 cases ,which applied the treatment of dinoprostone bolt the posterior fornix of vagina medicine induced abortion. The oxytocin group had 2I ca- ses,which applied the treatment of intravenous drip oxytocin. The time of induction labor, 6h, 12h cervical Bishop score after using the medication, drugs acting time, labor conditions and perinatal situation, pregnancy outcome and some other index were observed. Results It taken （ 6.18 ± 4.48 ） h until parturient and （ 12.62 ± 8.03 ） h until the cervical mouth full open in the dinoprostone group, which were shorter than the oxytocin group, that taken （10.21 ± 5.42） h, （ 18.87 ± 9.14 ） h. （ t = 2.62,2.35, all P 〈 0.05 ）. There was no significant difference about cervical Bishop score before using the medication. It＇s（7.52 ± 2.44 ）point 6h after using the medication and（9.03 ± 1.96 ）point 12h after in the dinoprostone group. They were better than the oxytocin group, which were （5.97 ± 1.95 ）point, （7.13 ± 2. 12 ） point. It was significantly different （ t = 2.27,3.02, all P 〈 0.05 ）. The average incubation period of dinoprostone group wss （ 9.91 ± 1.73 ） h. It＇s longger than the oxytocin group, which was （ 8.72± 1.34 ） h. The active period of dino- prostone group was （4.36 ± 0.66 ）h. It＇s shortter than the oxytoein group, which was （5.84 _± 1.02 ）h. The difference was significant（ t = 2.49,5.58, all P 〈 0.05 ）. There was no significant difference in the second and third stage of la- bor between the two groups（ t --- 0.56,0.33 ,all P 〉 0.05 ）. There was also no significant difference about intrauterine distress, amniotic fluid contamination, cesarean section, intestinal bleeding, the Apgar score of newborns and some oth- er index in the two groups （ X2 = 0. 00 , 0. 00 , 0. 52 , t = 0.84,1.04, all P 〉 0.05 ）. Conclusion Dinoprostone had good promoting effect on cervical ripening for preterm premature rupture of membranes pregnant woman. Its effect was better than oxytocin and it was safe to use.