地诺前列酮栓和缩宫素对促宫颈成熟及分娩结局的影响

Effect of dinoprostone suppositories and oxytocin in promoting cervical ripening and childbirth outcome

目的探讨在妊娠晚期引产中使用地诺前列酮栓和缩宫素对宫颈成熟度及分娩结局的影响。方法选取于东阳市人民医院巍山分院妇产科接受诊治的妊娠晚期引产孕妇174例,随机分为2组,即对照组85例和研究组89例,其中对照组采用常规引产方式静脉滴注缩宫素,研究组应用地诺前列酮栓,观察2组患者在引产药物干预后的引产有效率及不良反应发生情况,其中患者的临床效果以Bishop评分法判断宫颈成熟度,分娩结局以引产时间、自然分娩率、剖宫率、产妇产后出血量及新生儿窒息评分为评价标准。结果研究组患者在用药24 h后宫颈成熟度达到（7.26±1.82）分,比对照组（6.34±1.37）分提高显著（P〈0.05）。研究组患者的引产时间、自然分娩率、剖宫率依次为（6.34±1.37）h、86.52%、13.48%结果明显优于对照组（P〈0.05）。研究组产妇平均出血量为（225.96±12.81）mL、新生儿窒息评分为（9.73±0.15）分,结果均低于对照组（P〈0.05）。研究组患者的引产成功率为96.63%高于对照组85.88%;研究组患者的不良反应发生率为10.11%明显低于对照组21.18%（P〈0.05）,差异具有统计学意义。结论地诺前列酮栓用于妊娠晚期引产对促进宫颈成熟效果明显比缩宫素具有优势,能够缩短引产时间,提高自然分娩率并且对母婴预后结局良好,可以作为一种安全有效的临床引产方式。

Objective To explore the effect of dinoprostone suppositories and oxytocin on cervical maturation and delivery outcome in induction of labor in late pregnancy.Methods A total of 174 pregnant women in the department of obstetrics and gynecology in our hospital for treatment in late pregnancy were chosen.They were randomly divided into two groups：the control group 85 cases and the study group 89 cases.The control group was treated with routine induction of intravenous infusion of oxytocin,and the study group was taken with dinoprostone suppositories.The effective rates of induction of labor and the incidence of adverse reactions after induction of labor induced of the two groups were observed.The clinical effect of patients was with Bishop score to determine cervical maturity.The induction of labor time,natural childbirth rate,cesarean section rate,maternal postpartum hemorrhage and neonatal asphyxia score were as the evaluation criteria of childbirth outcome.Results The cervical maturation level was（7.26±1.82）after drug for 24 hours in the study group,significantly higher than that of the control group（6.34±1.37）（P〈0.05）.The induction time,spontaneous delivery rate and cesarean section rate of the study group were（6.34±1.37） h,86.52%,13.48%,significantly better than those in the control group（P〈0.05）.The average amount of bleeding in the study group was（225.96±12.81） mL and the neonatal asphyxia score was（9.73±0.15）,the results were lower than the control group（P〈0.05）.The successful rate of induction of labor in the study group was 96.63%） higher than that in the control group 85.88%.The incidence of side effects in the study group was 10.11%,significantly lower than in the control group 21.18%（P〈0.05）,which were with statistical significance.Conclusion Dinoprostosterone suppositories have the advantage of promoting cervical ripening for late pregnancy in pregnant women compared with oxytocin.It can shorten induction time and improve natural childbirth rate.And the maternal prognosis is good,can be used as a safe and effective clinical induction.