米索前列醇晚期引产的临床研究

Clinical study of misoprostol for the induced labor of late pregnancy

目的通过不同剂量、不同时间的米索前列醇阴道给药,观察其在晚期妊娠引产中的临床疗效和安全性,探索米索前列醇阴道用药的剂量和方法。方法180例符合引产指征的足月妊娠妇女随机分为6组,其中5组分别阴道内放置米索前列醇引产,剂量和时间分别为12.5μg q6 h(A组),25μg q6 h(B组),25μg q12 h(C组),50μg q6 h(D组),50μg q12 h(E组),1组为对照组,静脉点滴催产素引产。结果 A组24,48 h引产成功率低于对照组,B、C、D、E组引产成功率均高于对照组(P<0.05),4组间差异无统计学意义(P>0.05)。A、B、C、D、E组剖宫产率低于对照组,阴道分娩率高于对照组(P<0.05);B、C、D、E组产程显著短于对照组(P<0.01);B、C组引产48 h成功率差异无统计学意义(P>0.05)。结论 25μg q6 h米索前列醇引产成功率高,阴道分娩率高,剖宫产率低且宫缩过强,且不良反应发生率低,为临床值得推荐的剂量和方法。

Objective To observe the clinical effect and safety of miso-prostol in the treatment of induced labor of late pregnancy by different dosage and different time through vaginal delivery, and explore the dos-age and method of misoprostol vaginal delivery.Methods A total of 180 cases in induced labor indications of full term pregnant women were ran-domly divided into six groups, including five groups for medicines, re-spectively using vaginal placing misoprostol in induced labor, dosage and time were 12.5 μg q6 h （ A group ） , 25 μg q6 h （ B group ） , 25 μg q12 h （ C group） , 50μg q6 h （ D group） , 50μg q12 h （ E group） , an-other group of intravenous drip of oxytocin induced labor group （ control group） .Results The success rate of 24 h and 48 h to induced labor in A group was lower than that of control group, but B, C, D, E groups were higher than control group（P〈0.05）, no significant differences be-tween B, C, D, E groups（ P〉0.05）; the rate of cesarean section in medicines groups were lower than that of control group, and the rate of viginal delivery were higher than that of control group （ P〈0.05 ）; the stages of labor in B, C, D, and E groups were significantly shorter than that of control group （ P 〈0.01 ）; 48 h success rate of 25 μg induced labor was no difference between B and C groups （ P 〉0.05 ） . Conclusion Patients in B group had a high success rate of induced la-bor and high vaginal delivery rate, too low cesarean section rate and low rate of side effects such as contractions and amniotic fluid.Thus, 25 μg q6 h misoprostol is the recommended dose and method for patients.