米非司酮在瘢痕子宫胎盘前置引产中的应用效果

Application Effect of Mifepristone in Induced Abortion of Scarred Uterine Placenta Previa

【目的】探讨米非司酮在瘢痕子宫胎盘前置引产中的应用效果。【方法】选择陕西中医药大学第二附属医院2019年5月至2021年5月收治的80例瘢痕子宫胎盘前置的引产孕妇,按照随机抽签法分为观察组和对照组,每组40例。观察组口服米非司酮,第3天在超声定位下采用宫体注射方式向羊膜腔里注射乳酸依沙吖啶注射液100 mg进行引产;对照组采用宫体注射方式经羊膜腔里注射乳酸依沙吖啶注射液100 mg进行引产。比较两组孕妇引产效果、引产情况、手术前后性激素水平、预后情况以及不良反应发生率。【结果】观察组引产成功率为97.50%,显著高于对照组的82.50%,差异有统计学意义(P<0.05);观察组手术时间、出血量少于对照组,术后VAS评分低于对照组,差异均有统计学意义(P<0.05);两组孕妇术后性激素水平均下降,且观察组性激素水平低于对照组(P<0.05);观察组术后出现弥散性血管内凝血、产褥病占比低于对照组,同时血性恶露时间和月经恢复时间少于对照组(P<0.05),但两组子宫切除率、不良反应发生率比较,差异无统计学意义(P>0.05)。【结论】米非司酮用于瘢痕子宫胎盘前置引产中的效果显著,可减少手术时间和出血量,减轻患者疼痛感,改善患者性激素水平和预后情况,且未明显增加不良反应发生率,值得临床推广应用。

【Objective】To explore the application effect of mifepristone in induced abortion of scar uterine placenta previa.【Methods】A total of 80 induced abortion pregnant women with scar uterine placenta previa admitted to the Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from May 2019 to May 2021 were randomly divided into an observation group and a control group,with 40 cases in each group.The observation group received oral mifepristone,and on the third day,100 mg of ethacridine lactate injection was injected into the amniotic cavity under ultrasound localization to induce labor;The control group was induced labor by injecting 100 mg of ethacridine lactate injection into the amniotic cavity through intrauterine injection.Two groups of pregnant women were compared in terms of induction effect,induction status,preoperative and postoperative sex hormone levels,prognosis,and incidence of adverse reactions.【Results】The success rate of induced abortion in the observation group was 97.50%,significantly higher than 82.50%in the control group,with a statistically significant difference(P<0.05);The observation group had less surgical time and bleeding volume than the control group,and the postoperative VAS score was lower than that of the control group,with statistical significance(P<0.05);The levels of sexual hormones in both groups of pregnant women decreased after surgery,and the levels of sexual hormones in the observation group were lower than those in the control group(P<0.05);The proportion of postoperative disseminated intravascular coagulation and postpartum disease in the observation group was lower than that in the control group,while the time for bloody lochia and menstrual recovery was shorter than that in the control group(P<0.05).However,there was no statistically significant difference in the rate of hysterectomy and incidence of adverse reactions between the two groups(P>0.05).【Conclusion】The use of mifepristone in induced abortion of scar uterine placenta previa has a significant effect,reducing surgical time and bleeding,alleviating patient pain,improving patient sex hormone levels and prognosis,and does not significantly increase the incidence of adverse reactions.It is worth promoting and applying in clinical practice.