瘢痕子宫中期引产中米非司酮联合依沙吖啶的应用效果分析

Analysis on the application effect of mifepristone combined with ethacridine in the induction of labour in the second trimester induced by scarred uterus

目的研究并分析对中期引产的瘢痕子宫患者使用米非司酮联合依沙吖啶的效果和价值。方法收集2014年1月~2017年1月间在我院接受中期引产的瘢痕子宫患者50例,根据随机分组原则将其分为对照组(n=25)和观察组(n=25),对照组的引产药物为依沙吖啶,观察组在对照组基础上在联合使用米非司酮,将两组宫缩开始时间、宫缩到胎盘娩出时间、产后出血量、引产成功率、清宫率、胎膜胎盘残留发生率以及软产道裂伤发生率进行观察和对比。结果观察组的宫缩开始时间、宫缩到胎盘娩出时间、产后出血量分别为(15.38±4.12)h、(8.37±1.18)h、(112.58±5.95)m L均显著优于对照组;对比两组引产成功率,观察组100.00%显著高于对照组的84.00%;在清宫率、胎膜胎盘残留发生率以及软产道裂伤发生率方面,观察组均显著低于对照组(P均<0.05)。结论在中期引产的瘢痕子宫患者的治疗过程中,米非司酮联合依沙吖啶能够显著缩短产程,减少软产道损伤及产后的出血量,提高引产安全性及引产的成功率,值得推广应用。

Objective To study and analyze the effect and application value of mifepristone combined with escacridine in the induction of labor in the second trimester induced by scarred uterus. Methods A total of 50 patients with scarred uterus who were given induction of labor in the second trimester in our hospital from January 2014 to January 2017 were collected. According to the computerized simple randomization principle, the patients were assigned to the control group（n=25） and observation group（n=25）. The drug for induction of labor was escacridine in the control group, and the observation group was on the basis of the control group combined use of mifepristone. The start time of uterine contraction, the time from uterine contraction to delivery of placenta, the amount of postpartum bleeding, the success rate of induced labor, the incidence of postpartum hemorrhage, the clearance rate of uterus, the incidence rate of residual fetal membrane and placenta, and the incidence rate of soft birth canal laceration were observed and compared. Results The start time of uterine contraction, the time from uterine contraction to delivery of placenta, and the amount of postpartum hemorrhage in the observation group were（15.38 ±4.12）h,（8.37 ±1.18）h and（112.58 ±5.95）m L respectively,which were significantly better than those in the control group; The success rate of induction of labor was compared between the two groups, and it was 100.00% in the observation group, which was significantly higher than that of 84.00%in the control group; in terms of the clearance rate of uterus, the incidence rate of residual fetal membrane and placenta, and the incidence rate of soft birth canal laceration, the observation group was significantly lower than the control group（P〈0.05 for all）. Conclusion During the course of treatment in the induction of labor in the second trimester induced by scarred uterus, mifepristone combined with escacridine can significantly shorten the labor process, reduce the number of soft birth canal damage and postpartum hemorrhage, improve the safety of induction of labor and the success rate of induction of labor, which is worthy of promotion and application.