两种方法用于疤痕子宫中期妊娠引产的临床分析

Clinical Analysis of Two Methods in the Midtrimester Induction of Labor of Uterine Scar

目的探讨一种疤痕子宫中期妊娠引产的安全有效方法 ,以利于计划生育工作的顺利开展。方法选择2010年1月—2012年12月该院纳入16~24周之间自愿要求终止妊娠的疤痕子宫孕妇共80例,参考随机法将患者均分为两组,一组收入患者40例,观察组患者开展利凡诺羊膜腔内注射引联合米非司酮配伍米索前列醇治疗,对照组患者开展利凡诺羊膜腔内注射引产单独治疗。观察且比较对照组和观察组患者两组宫缩发动时间、胎儿娩出时间、胎盘娩出情况、产后出血量、软产道损伤及引产成功率。结果观察组疤痕子宫中期妊娠患者引产成功率100.00%、用药至宫缩时间(20.43±3.50)分、胎儿胎盘娩出时间(27.69±3.70)h、总产程(6.95±3.95)h对比对照组的95.00%、(32.55±3.30)分、(43.04±3.52)、(14.98±3.74)h,差异有统计学意义(χ~2=8.658 0,t=15.934 3,19.009,9.336 2,P<0.01)。结论将利凡诺羊膜腔内注射引联合米非司酮配伍米索前列醇治疗应用在疤痕子宫中期妊娠引产患者中具有显著作用,可增加安全性,引产时间缩短,并发症减少,大大减轻患者痛苦,值得临床推广应用。

Objective To study a safe and effective method of midtrimester induction of labor of uterine scar to promote the successful development of family planning work. Methods 80 cases of delivery women with uterine scar requiring the doctors to terminate the pregnancy voluntarily after 16-24 w in our hospital from January 2010 to December 2012 were selected and randomly divided into two groups with 40 cases in each, the observation group used the amniotic intravinic injection of rivanol, misoprostol combined with mifepristone, while the control group used the amniotic intravinic injection of rivanol, and the uterine contraction initiation time, fetal delivery time, placental delivery, postpartum hemorrhage, soft birth canal injury and induced labor success rate were observed and compared. Results The induced labor successful rate, time from medication to uterine contraction, delivery time of fetal placenta and total labor course in the observation group and in the control group were respectively 100.00%,（20.43±3.50）points,（27.69±3.70）h,（6.95±3.95）h and 95.00%,（32.55±3.30）points,（43.04±3.52）h,（14.98±3.74）h,and the differences were statisticall signficant（χ~2=8.658 0,t=15.934 3,19.009,9.336 2,P0.01）. Conclusion The application effect of amniotic intravinic injection of rivanol, misoprostol combined with mifepristone in the midtrimester induction of labor of uterine scar is ovios, which can increase the safety, shorten the induced labor time, reduce the complications and greatly relieve the pains of patients, and it is worth clinical promotion and application.