摘要
目的:探讨控释地诺前列酮栓用于足月妊娠引产的临床效果与安全性。方法:对2009年1月～2010年3月250例应用控释前列酮栓与220例使用缩宫素引产的病例进行回顾性分析。结果:①试验组用药4小时、6小时及12小时后平均宫颈Bishop评分5.72±1.12,7.22±1.45分,7.81±1.73分,而对照组分别为4.42±1.14分,5.07±1.78分,5.4±1.62分,差异有显著性(P<0.05)。②试验组的第一产程、第二产程及总产程短于对照组,差异有统计学意义(P<0.05);对照组用药后至规律宫缩明显短于观察组,差异有统计学意义(P<0.05)。③研究组24小时引产成功率68%,失败率12%,对照组平均24小时引产成功率51%,失败率20%,差异有显著性(P<0.05)。④两组分娩方式与剖宫产指征无统计学差异。两组产后出血量、新生儿体重、新生儿Apgar评分、新生儿窒息发生率差异无显著性(P>0.05)。⑤控释地诺前列酮栓的不良反应为子宫过度刺激,发生率1.6%。结论:与催产素相比,控释地诺前列酮栓促宫颈成熟作用显著,引产成功率高、特别适于宫颈Bishop评分低者使用,且不增加胎儿窘迫发生率及手术产率,也不增加新生儿窒息及产褥感染率,是有效、安全的。
Objective：To explore the efficacy and safety of controlled -released dinoprostone used in term pregnancies induction. Methods： 250 cases used Controlled -release dinoprostone and 220 cases used oxytocin for labour induction between Jan ,2009 to Mar, 2010 were recorded and investigated. Results ： （1）The Bishop score 4 hours, 6 hours and 12 hours after medication was 5. 72±1. 12,7.22 ±1.45,7.81 ±1.73 in study group ,while it was 4.42 ± 1.14,5.07 ± 1.78,5.4 ± 1.62 in control group. There were differences between two groups （ P 〈 0. 05）. （2）The lengths of the first stage, the scend stage and the total stage of labour in study group were shorter than those in control group. The average time of using drug to beginning contraction in study group was longer than that in control group. There were significant differeces between two groups （P 〈 0. 05 ） ; （3） The achievement ratio in 24 hours and the defeat ratio in study group was 68% and 12%, while that in control group was 51%, and 20%, There were significant differeces between two groups （ P 〈 0. 05 ）. （4）There was no difference in delivery type , operation index, incidence of fetal distress and post - partum haemorrhage or infection. （5）The chief side effect of controlled - re leased dinoprostone was hyperstimulation on uterus and the incidence was 1.6%. Conclusions： Controlled - release dinoprostone was more effective than oxytocin in cevical ripening for medical induction in term pregnancies, especially in the low Bishop score cases. Controlled - release dinoprostone does not induce adverse maternal or fetal morbidity.
关键词
地诺前列酮
宫颈成熟
妊娠
Controlled - release dinoprostone
cervical ripening
labor induction
