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目的探讨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。方法选择2008年11月—2012年10月收治的中期妊娠引产患者245例,分为瘢痕组87例和对照组158例,其中,瘢痕组又分为单药组35例及联合用药组52例。单药组及对照组均经腹羊膜腔内注入依沙吖啶100 mg,联合用药组在上述基础上,于当晚、次日晨及次日晚9时各口服米非司酮50 mg,服药前后均空腹2 h。观察其引产结局、宫缩发动时间、胎儿排出时间、阴道出血量及并发症发生情况。计量资料采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果瘢痕组与对照组引产成功率、宫缩发动时间、阴道出血量、并发症发生率比较差异均无统计学意义(均P>0.05),胎儿排出时间瘢痕组[(12.34±5.16)h]长于对照组[(10.29±3.52)h],差异有统计学意义(t=3.283,P<0.05)。胎儿排出时间单药组[(14.36±6.42)h]长于联合用药组([11.29±4.65)h],差异有统计学意义(t=2.700,P<0.05)。单药组与联合用药组宫缩发动时间及阴道出血量比较差异均无统计学意义(均P>0.05)。结论依沙吖啶用于瘢痕子宫中期引产安全有效,配伍米非司酮可明显缩短产程,减轻患者痛苦。
Objective To investigate the clinical efficacy of ethacridine combined with mifepristone in the induction of labor induced by scar pregnancy. Methods From November 2008 to October 2012, 245 pregnant women with mid-term pregnancy induced abortion were divided into scar group (n = 87) and control group (n = 158). The scar group was divided into single drug group (n = 35) and combination group . The single drug group and the control group were given amniotic 100 mg via intraperitoneal amniotic cavity, and on the basis of the above, the combination group took 50 mg of mifepristone on the evening, the next morning and the next day after 9 pm. Before and after fasting 2 h. Observe the outcome of induction of labor, uterine contraction time, fetal discharge time, vaginal bleeding and complications. Measurement data using t test, count data using χ2 test, P <0.05 for the difference was statistically significant. Results There were no significant differences in the success rate of induction of labor, the time of uterine contractions, the volume of vaginal bleeding and the incidence of complications between the scar group and the control group (all P> 0.05), and the scarring group [(12.34 ± 5.16) h] (10.29 ± 3.52) h, the difference was statistically significant (t = 3.283, P <0.05). The fetal discharge time of single drug group (14.36 ± 6.42 h) was longer than that of the combined drug group (11.29 ± 4.65 h). The difference was statistically significant (t = 2.700, P <0.05). There was no significant difference in the time of uterine contractions and the volume of vaginal bleeding between the monotherapy group and the combination therapy group (all P> 0.05). Conclusions Ethacridine is safe and effective for mid-term abortion of scar uterine. Compatibility with mifepristone can shorten the labor process and relieve patient’s pain.