乳酸依沙吖啶、米非司酮、米索前列醇不同给药方法用于瘢痕子宫中期妊娠引产的比较

摘要

目的 探讨瘢痕子宫中期妊娠(妊娠16～26周)不同引产结果 的疗效.方法 将90例瘢痕子宫中期妊娠自愿要求引产的孕妇随机分为A、B、C三组,每组30例,A组采取乳酸依沙吖啶羊膜腔内注射联合阴道放置米索前列醇,B组采取口服米非司酮联合乳酸依沙吖啶羊膜腔内注射,C组采取口服米非司酮联合阴道放置米索前列醇.观察三种引产结果 宫缩发动时间、排胎时间、阴道出血量、完全流产率及术后清宫率.结果 三种引产结果 完全流产率比较,差异无统计学意义(P ＞ 0.05);B组在宫缩发动时间和阴道出血量方面显著少于A组和C组(P ＜ 0.01);B组和C组在排胎时间方面少于A组;B组术后清宫率显著低于A组和C组.结论 三种引产结果 应用于瘢痕子宫中期妊娠引产各有利弊,其中米非司酮口服联合乳酸依沙吖啶羊膜腔内注射法用于引产阴道出血量少,术后清宫率低,不良反应少,明显优于其他两种引产方式,适合临床推广应用.%Objective To discuss the curative effect of different methods for induced labor in second trimester pregnancy (16-26 weeks of pregnancy) with scarred uterus. Methods 90 pregnant women in second trimester pregnancy with scarred uterus who asked for induced labor voluntarily were divided into groups A, B and C randomly, with 30 cases in each group. And group A was treated by amniocentesis injection Ethacridine Lactate combined with vaginal Misoprostol; group B was treated by orally Mifepristone combined with amniocentesis injection Ethacridine Lactate; and group C was treated by orally Mifepristone combined with vaginal Misoprostol. And then the contractions launch time, fetus discharge time, vaginal bleeding volume, completely abortion rate, and postoperation cleaning rate of three methods for induced labor were observed. Results There were no statistically significant differences (P > 0.05) compared with completely abortion rate of three methods for induced labor; group B was obviously less than group A and group C (P < 0.01) in terms of contractions launch time and vaginal bleeding volume; group B and C were less than group A in terms of fetus discharge time; group B was obviously less than group A and group C in terms of postoperation cleaning rate. Conclusion There are pros and cons for the application of three methods for induced labor to second trimester pregnancy with scarred uterus, of which, less vaginal bleeding volume, lower postoperation cleaning rate, and fewer side effects used to induced labor for the method of taking orally mifepristone combined with amniocentesis injection ethacridine lactate, which is obviously superior to other two methods for induced labor, suit to be used in clinic.