地诺前列酮栓用于足月妊娠产妇引产的临床观察

Clinical Observation of Dinoprostone Suppository for Induction of Term Pregnancy

目的：观察地诺前列酮栓用于足月妊娠产妇引产的临床疗效和安全性。方法：选择111例足月妊娠初产妇，按随机数字表法分为对照组（50例）和观察组（61例）。两组产妇均排尿后行外阴消毒，观察组产妇于阴道后穹隆处放置地诺前列酮栓1枚，卧床2h后可自由活动；对照组产妇给予催产素2．5u加入5％葡萄糖溶液500ml中静脉滴注，以8滴／min开始，根据宫颈收缩情况调节滴速至有效宫颈收缩（2～3次／10min），每次持续30S。观察两组产妇引产效果，分娩情况，产后出血量及分娩结果；记录所有新生儿情况；观察两组产妇不良反应发生情况。结果：观察组产妇总有效率显著高于对照组，两组比较差异有统计学意义（P〈0．01）；观察组产妇引产时间、总产程较对照组显著缩短，两组比较差异有统计学意义（P〈0．01），但两组产妇产后出血量比较差异无统计学意义（P〉0．05）；观察组产妇阴道分娩率显著高于对照组，剖宫产率显著低于对照组，两组比较差异均有统计学意义（P〈0．01）；两组新生儿情况和产妇不良反应发生率比较差异均无统计学意义（P〉0．05）。结论：地诺前列酮栓可安全用于足月妊娠产妇引产，不仅可以提高阴道分娩率，而且安全．洼较好。

OBJECTIVE： To observe clinical efficacy and safety of Dinoprostone suppository for induction of term pregnancy. METHODS： 111 premiere were randomly divided into observation group （61 cases） and control group （50 cases）. 2 groups received vulvar disinfection after urinating. Observation group were treated with one piece of Dinoprostone suppository on posterior vaginal fornix; delivery woman could move freely after remaining in bed for 2 h. Control group was given intravenous dripping of oxytocin 2.5 u added into 5% glucose 500 ml at initial rate of 8 drops/rain. The dripping speed should be adjusted to effective value （2-3 times/10 min, lasting for 30 s each time） according to the situation of uterine contraction. The situation and results of labor induction and delivery were observed in 2 groups; The situation of neonate was recorded; the occurrence of ADR was observed in 2 groups. RESULTS： Total effective rate of observation group was significantly higher than that of control group; there was statistical significance （P〈0.01）. The induction time and delivery time of observation group were shortened significantly, compared with control group; there was statistical significance （P〈0.01）. There was no significant difference in postpartum hemorrhage between 2 groups （P〉0.05）. Compared with control group, normal labor rate of observation group was higher but cesarean section rate was significantly （lower than control group）; there was statistical significance （P〈0.01）. There were no statistical significance in the incidence of ADR and new born between 2 groups （P〉0.05）. CONCLUSIONS： Dinoprostone suppository is safe and effective for induction of term pregnancy and can improve normal labor rate and shows good safety.