依沙吖啶羊膜腔注射联合米非司酮用于16~26孕周引产的临床研究

摘要/Abstract

摘要： 目的探讨依沙吖啶羊膜腔注射联合米非司酮用于16~26孕周引产的临床效果。方法选取2019年2月~2022年2月在新余市人民医院主动要求终止妊娠的68例妊娠期妇女,采用随机数表法将患者分为观察组和对照组,每组34例。对照组采用羊膜腔内注射依沙吖啶100 mg引产。观察组口服米非司酮片100 mg/次,Q12 h,连续服用2 d,服药前后2 h禁食,第3天采用常规方法,行羊膜腔内注射依沙吖啶引产。观察记录两组患者用药至规律宫缩时间、规律宫缩至胎儿娩出时间、产后2 h出血量、住院时间、引产效果[完全流产（胎儿、胎膜胎盘完全娩出）、不完全流产（胎膜胎盘仍有残留,需清宫）、流产失败（用药72 h后仍未见胎儿娩出）]。采用Mulleetr法记录两组患者引产疼痛程度;对患者进行2个月随访,比较两组患者月经复潮时间及经期持续时间;记录两组患者不良结局发生情况。结果观察组用药至规律宫缩时间、规律宫缩至胎儿娩出时间以及产后2 h出血量明显低于对照组,差异有统计学意义（P<0.05）;观察组完全流产率明显高于对照组,差异有统计学意义（P<0.05）;观察组清宫率明显低于对照组,差异有统计学意义（P<0.05）。两组患者最终引产成功率、月经来潮及经期持续时间比较,差异无统计学意义（P>0.05）。两组患者疼痛程度比较,差异无统计学意义（P>0.05）。两组患者均未发生强直性宫缩、子宫破裂等严重不良结局。两组患者总不良结局发生率比较,差异无统计学意义（P>0.05）。结论依沙吖啶羊膜腔注射联合米非司酮用于16~26孕周妊娠引产临床效果确切,可缩短引产相关时间,减少产后出血量,提高完全流产率。

关键词: 依沙吖啶, 米非司酮, 引产

Abstract: Objective To explore the clinical application effect of intra-amniotic injection of ethacridine combined with mifepristone in induced labor during gestational age of 16-26 weeks. Methods Sixty-eight pregnant women voluntarily requesting termination of pregnancy in the Xinyu People's Hospital were enrolled form February 2019 and February 2022. Patients were divided into observation group and control group by random number table method, 34 cases in each group. The control group were given intra-amniotic injection of ethacridine (100 mg). While the observation group were given oral mifepristone tablets (100 mg Q12 h) for 2 d. The fasting was necessary for at 2 h before and after medication, on the third day, the routine methods were applied, gave intra-amniotic injection of ethacridine (100 mg). And then they were given intra-amniotic injection of ethacridine for induced labor. The interval from medication to regular uterine contraction, interval from regular uterine contraction to fetal delivery, blood loss at 2 h after delivery, hospitalization time and induced labor effect [complete abortion (complete delivery of fetuses, fetal membranes and placenta), incomplete abortion (curettage, residual fetal membranes and placenta), abortion failure (no fetal delivery at 72 h after medication)] in both groups were observed and recorded. The pain degree of induced labor was recorded by Mulleetr method. All patients were followed up for 2 months to compare re-menstruation time and menstrual duration between the two groups. The occurrence of adverse outcomes in both groups was recorded. Results The interval from medication to regular uterine contraction, interval from regular uterine contraction to fetal delivery and blood loss at 2 h after delivery in observation group were significantly lower than those in control group (P<0.05). The complete abortion rate in observation group was significantly higher than that in control group (P<0.05), and curettage was significantly lower than that in control group (P<0.05). There was no significant difference in final success rate of induced labor, re-menstruation time or menstrual duration between the two groups (P>0.05). There was no significant difference in pain degree between the two groups (P>0.05). There were no serious adverse outcomes (tonic uterine contraction, uterine rupture) in either group.There was no statistical difference in the incidence of total adverse outcomes between the two groups (P>0.05). Conclusion The clinical application effect of intra-amniotic injection of ethacridine combined with mifepristone is significant in induced labor during gestational age of 16~26 weeks, which can shorten the time related to induced labor, reduce postpartum blood loss, increase complete abortion rate.

Key words: ethacridine, mifepristone, induced labor

中图分类号:

R714

陈琳. 依沙吖啶羊膜腔注射联合米非司酮用于16~26孕周引产的临床研究[J]. 中华养生保健, 2022, 40(15): 18-22.

CHEN Lin. Clinical Application of Intra-amniotic Injection of Ethacridine Combined with Mifepristone in Induced Labor during Gestational Age of 16-26 Weeks[J]. ZHONGHUA YANGSHENG BAOJIAN, 2022, 40(15): 18-22.

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