催产素联合地诺前列酮栓对妊娠期高血压疾病引产的疗效与安全性

The Effect and Safety of Ocytocin Combined with Dinoprostone Suppository to Induce Labor for Parturients with Hypertensive Disorder Complicating Pregnancy

目的观察催产素联合地诺前列酮栓对妊娠期高血压疾病产妇引产的临床疗效及安全性。方法选取2014年1月至2015年1月沈阳市妇婴医院产科收治的妊娠期高血压疾病产妇142例,按抽签法随机分为两组。对照组73例,接受地诺前列酮栓引产;观察组69例,接受催产素联合地诺前列酮栓引产。其中对照组采用地诺前列酮栓10mg置入阴道引产,观察组予以催产素2.5U静脉滴注联合地诺前列酮栓10mg置入阴道引产。比较两组产妇的血压水平、Bishop评分、引产成功率、24h出血量及不良反应发生情况。结果两组产妇用药前、用药12h后、用药24h后平均动脉压均呈先升高后降低趋势[观察组:(123±6)mmHg(1mmHg=0.133kPa)、(120±5)mmHg比(117±5)mmHg;对照组:(123±6)mmHg、(119±5)mmHg比(119±6)mmHg],两组在组间、时点间、组间·时点间交互作用差异无统计学意义(P>0.05)。用药12h后观察组Bishop评分显著高于对照组[(9.2±1.7)分比(8.3±1.4)分,P<0.01];观察组产妇总产程时间显著短于对照组[(353±103)min比(619±128)min,P<0.01];观察组引产成功率显著高于对照组[97.1%(67/69)比54.8%(40/73),P<0.05]。观察组24h出血量显著少于对照组[(180±45)mL比(226±51)mL](P<0.01);观察组总不良反应发生率与对照组比较差异无统计学意义[14.5%(10/69)比9.6%(7/73),P>0.05]。结论合理调整催产素和地诺前列酮栓的剂量及使用时间,在妊娠期高血压疾病产妇的引产中取得了良好的效果。

Objective To investigate the clinical effect and safety of ocytocin combined with dinoprostone suppository to induce labor for parturients with hypertensive disorder. Methods From Jan. 2014 to Jan. 2015 in Shenyang Women＇s and Children＇s Hospital,142 parturients with hypertensive disorders were selected as research subjects and randomly divided into 2 groups by sortition. The control group including 73 cases was given 10 mg dinoprostone suppository into vagina,and the observation group including 69 cases was given 2. 5 U ocytocin combined with 10 mg dinoprostone suppository. The level of blood pressure,Bishop scores,success rate of induced labor. 24 h bleeding volume and adverse effect of the two groups were compared,respectively.Results After medicating,the two groups showed the same tendency of rising and then falling MAP[observation group：（ 123 ± 6） mm Hg,（ 120 ± 5） mm Hg vs（ 117 ± 5） mm Hg; control group：（ 123 ± 6） mm Hg,（ 119 ± 5） mm Hg vs（ 119 ± 6） mm Hg],there were no significant differences between groups,or among different time points,or among the interaction of groups and time（ P〈0. 05）. The Bishop scores of the observation group was significantly higher than the control group [（ 9. 2 ± 1. 7） score vs（ 8. 3 ± 1. 4） score,P〉0. 01]. The birth process time of the observation group was shorter than the control group[（ 353 ± 103） min vs（ 619 ± 128） min,P〈0. 01]. Induced labor success rate of the observation group was significantly higher than the control group[97. 1%（ 67 /69） vs 54. 8%（ 40 /73）,P〈0. 05]. Bleeding volume of the observation group was significantly less than the control group[（ 180 ± 45） m L vs（ 226 ± 51） m L,P〈0. 01]. There was no significant difference in the adverse effect between observation group and control group[14. 5%（ 10 /69）vs 9. 6%（ 7 /73）,P 〉0. 05]. Conclusion By adjusting the dose and using time of ocytocin and dinoprostone suppository appropriately,good effect can be achieved in the treatment of parturients with hypertensive disorder.