妊娠中期羊水过少患者引产方法探究

Exploring labor induction methods for patients at second trimester of pregnancy with oligohydramnios

目的探讨妊娠中期羊水过少患者采用两种不同的引产方法进行引产的临床效果。方法将86例需要引产的妊娠中期羊水过少患者分成两组,实验组使用复方米非司酮配伍米索前列醇进行引产,对照组使用利凡诺进行引产。观察两组的引产成功率、产后2h内出血量、胎儿娩出时间、产道损伤、不良反应发生情况、患者疼痛程度等临床指标。结果实验组引产成功率明显高于对照组,结果具有统计学差异(x^2=27.973,P<0.05),实验组产后2h出血量以及胎盘娩出时间均显著低于对照组(t值分别为3.423、7.316,均P<0.01)。两组患者产道损伤和不良反应发生率无明显差异(/值分别为0.212、1.811,均P>0.05)。实验组Ⅰ、Ⅱ级疼痛人数均明显高于对照组人数(x^2值分别为4.170、7.167,均P<0.05),Ⅲ、Ⅳ级疼痛人数均明显低于对照组人数,结果均有统计学差异(x^2值分别为7.026、7.679,均P<0.05)。结论妊娠中期羊水过少患者使用复方米非司酮配伍米索前列醇引产比使用利凡诺效果好,具有简单,安全,副作用小等优点。

Objective To investigate the clinical effects of two different methods on labor induction at second trimester of pregnancy with oligohydramnios.Methods Totally 86 cases of second trimester of pregnancy with oligohydramnios needing induction of labor were divided into two groups, experimental group using Mifepristone and Misoprostol to induce labor, and control group using Rivanol.The success rate of labor induction, postpartum hemorrhage volume within 2 hours after birth, fetus delivery time, birth canal injury, incidence of adverse reaction and the degree of pain were observed and compared between two groups.Results The success rate of labor induction of the experimental group was higher than the control group with significant difference （χ^2 =27.973,P〈0.05）.Postpartum hemorrhage volume and placenta explusion of the experimental group were significantly less than the control group （t value was 3.423 and 7.316, respectively, both P〈0.01） .But the birth canal injury and incidence of adverse reaction of two groups showed no significant differences（χ^2 value was 0.212 and 1.811, respectively, both P 〉0.05）.The number of cases in the experimental group with pain of gradeⅠand Ⅱwas significantly higher than that in the control group （χ^2 value was 4.170 and 7.167, respectively, both P〈0.05） , while the number of cases with pain of gradeⅢand Ⅳwas significantly lower in the experimental group （χ^2 value was 7.026 and 7.679, respectively, both P〈0.05）.Conclusion Combined application of Mifepristone and Misoprostol obtains better effect on cases at second trimester of pregnancy with oligohydramnios than using Rivanol , and it is simple and safe with less side effects.