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目的观察依沙吖啶联合米非司酮用于瘢痕子宫中期妊娠引产的临床效果。方法将瘢痕子宫中期妊娠进行引产的孕妇76例随机分为单药组和联合组各38例。单药组予依沙吖啶羊膜腔内注射引产,联合给予依沙吖啶羊膜腔内注射+米非司酮口服引产。对比2组宫颈Bishop评分,宫缩发动、胎儿娩出时间,产后出血量,软产道损伤情况,引产成功率、妊娠物残留率。结果联合组注射依沙吖啶后5、10、15 h的宫颈Bishop评分均显著高于单药组,差异均有统计学意义(P<0.01)。联合组注射依沙吖啶后宫缩发动时间及胎儿娩出时间均短于对照组,产后24 h出血量少于单药组,差异均有统计学意义(P<0.01)。联合组软产道损伤率、妊娠物残留率均低于单药组,差异有统计学意义(P<0.05或P<0.01)。2组引产成功率比较差异无统计学意义(P>0.05)。结论瘢痕子宫中期妊娠引产采用依沙吖啶联合米非司酮可加快产程进展,提高引产效率,且安全性更佳。
Objective To observe the clinical effect of ethacridine combined with mifepristone in the induction of labor in the second trimester of uterine scar. Methods Seventy-six pregnant women who induced abortion by uterine scar pregnancy were randomly divided into single drug group and combined group (n = 38). Monotherapy group was given intranasal injection of ethambutol by induction of abortion, combined with intramuscular injection of amniotic fluid + mifepristone oral induction. The Bishop cervical score, uterine contractions, fetal delivery time, postpartum hemorrhage volume, injury of soft birth canal, success rate of induced abortion and residual rate of pregnancy were compared between two groups. Results The Bishop scores of cervix at 5, 10 and 15 h after injecting ethacridine in the combined group were significantly higher than those in the single drug group (P <0.01). In the combination group, the time of uterine contractions and the time of delivery were shorter than those of the control group. The amount of bleeding at 24 hours after delivery was less than that of the single drug group (P <0.01). The combined group of soft birth canal injury rate, pregnancy rate were lower than single drug group, the difference was statistically significant (P <0.05 or P <0.01). There was no significant difference in success rate of induction of labor between the two groups (P> 0.05). Conclusion The induction of labor in the second trimester of uterine scar with ethacryl combined with mifepristone can speed up the progress of labor, improve the efficiency of induction of labor and better safety.