间苯三酚联合米非司酮及利凡诺用于瘢痕子宫中期引产的临床疗效

Clinical effect of phloroglucinol combined with Mifepristone and Rivanol in course of terminating mid-trimester pregnancy on scar uterus

目的探讨间苯三酚联合米非司酮及乳酸依沙吖啶注射液(利凡诺)用于瘢痕子宫中期妊娠引产的临床疗效。方法选择2016年1月~2019年5月河北省第七人民医院瘢痕子宫中期妊娠(16~27周)要求终止妊娠的孕妇68例,采用随机数字表法将其分为观察组和对照组,其中观察组34例采用米非司酮联合利凡诺羊膜腔内注射,待规律宫缩后,宫口开大1 cm时,予以间苯三酚80 mg静脉推注。对照组34例单纯采用米非司酮联合利凡诺引产。观察两组引产时间、宫口扩张程度、患者疼痛程度、宫颈水肿及宫颈裂伤发生情况、引产成功率以及不良反应等,并记录引产出血量。结果观察组引产时间明显短于对照组,差异有统计学意义(P<0.05)。观察组疼痛程度明显低于对照组,差异有统计学意义(P<0.05)。两组引产成功、2 h宫口扩张超3 cm、宫颈水肿及宫颈裂伤者占比比较,差异有统计学意义(P<0.05)。两组引产出血量及不良反应发生率比较差异无统计学意义(P>0.05)。结论间苯三酚联合米非司酮及利凡诺用于瘢痕子宫中期妊娠引产临床效果良好,无明显不良反应,安全可靠,简便易行,值得临床推广。

Objective To observe clinic effect of using Phloroglucinol combined with Mifepristone and Ethacridine Lactate Injection(Rivanol)in course of terminating mid-trimester pregnancy on scar uterus.Methods A total of 68 women with scar uterus(16-27 weeks gestation)desiring to terminate mid-trimester pregnancy were selected,and then they were divided into observation group and control group by random number method.In the observation group,34 women were given Mifepristone and were injected abdominal intra-amniotically with Rivanol,as well given 80 mg of Phloroglucinol Injection intravenously when the cervix dilated 1 cm.In the control group,34 women only were induced by Mifepristone combined with Rivanol.The time duration,cervical dilatation,suffering of the patients,laceration of cervix,the cervix edema,success rate of terminating pregnancy and adverse reactions of the two groups were observed,and postpartum hemorrhage were taken record.Results Time duration of terminating pregnancy in the observation group was shorter than that in the control group,the difference was statistically significant(P<0.05).The pain degree in the observation group was significantly lower than that in the control group,the difference was statistically significant(P<0.05).There were statistically significant differences in the proportion of patients with successful labor induction,cervical dilatation over 3 cm in 2 h,cervix edema,laceration of cervix between the two groups(P<0.05).There was no statistically significant difference in postpartum hemorrhage and the incidence of adverse reactions(P>0.05).Conclusion Phloroglucinol combined with Mifepristone and Rivanol in terminating mid-trimester pregnancy on scar uterus have a good clinical effect.There is no obvious adverse reactions.It is safe and reliable,as well as simple and easy to operate.So it is worth to be widely promoted.