利凡诺尔联合Cook宫颈扩张球囊在妊娠中期引产中的应用

Application of ethacridine combined with cook cervical dilatation balloon in mid-pregnancy induced labor

目的探讨利凡诺尔联合Cook宫颈扩张球囊应用于妊娠中晚期引产的有效性及安全性。方法选择2015年12月至2017年2月由于各种原因(如胎死宫内、胎儿先心病、无脑儿等畸形)要求终止妊娠而来第四军医大学西京医院妇产科引产的孕妇200例。,将其随机分为两组,采用利凡诺尔联合Cook宫颈扩张球囊引产者为观察组,利凡诺尔引产者为对照组。比较两组孕妇取出球囊后宫颈评分、规律宫缩至胎儿娩出时间、产后出血及术后清宫率等指标。结果 (1)观察组在取出球囊后宫颈评分明显高于对照组,差异有统计学意义(t=25.10,P<0.05);(2)观察组宫缩发动至胎儿娩出时间和住院时间均少于对照组,差异有统计学意义(t值分别为21.54和15.14,均P<0.05);(3)观察组清宫率显著低于对照组,差异有统计学意义(χ2=8.30,P<0.05)。结论在妊娠中期引产中,利凡诺尔配合Cook宫颈扩张球囊能显著改善宫颈条件,有较高的安全性,并可缩短引产时间,降低住院时间及引产后清宫率,从而减轻产妇对疼痛的焦虑和体力消耗。因此,具有较好的临床推广应用价值。

Objective To understand the effectiveness and safety of ethacridine combined with cook cervical dilatation balloon in midpregnancy induced labor. Methods Two hundred pregnant women requiring termination of pregnancy because of fetal abnormality or death were divided into 2 groups. Patients undergoing induced labor with ethacridine combined with cook cervical dilatation balloon were assigned into observation group,and patients with ethacridine induced labor were divided into control group. Cervical Bishop score after extraction of balloon,time from regular uterine contraction to fetal disengagement,postpartum hemorrhage and curettage rate after surgery in two groups were analyzed and compared. Results Cervical Bishop score in the observation group after balloon extraction was higher than that in the control group,and difference had statistical significance（ t = 25. 10,P〈 0. 05）. Time from uterine contraction onset to fetal disengagement and length of stay in hospital in the observation group were both lower than those in the control group with significant differences（ t value was 21. 54 and 15. 14,respectively,both P〈 0. 05）. Curettage rate in the observation group was lower than that in the control group with statistically significant difference（ χ2 = 8. 30,P〈 0. 05）. Conclusion Ethacridine combined with cook cervical dilatation balloon can greatly improve cervical conditions and has high safety in induced labor in mid-pregnancy. It can shorten time of induced labor,reduce hospitalization stay and curettage rate so as to reduce maternal anxiety on pain and physical consumption. So it has preferable clinical popularization and application value.