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目的探讨水囊在妊娠合并肝功能异常的孕妇中期引产中的临床应用。方法对上海市公共卫生临床中心2014年6月-2016年6月收治的妊娠合并肝功能异常的14~27周孕妇引产临床资料进行回顾性分析,将患者分为水囊引产组(40例)、利凡诺羊膜腔内注射引产组(40例)及米非司酮配伍米索前列醇药物引产组(40例),并进行统计学处理。结果水囊引产组宫缩开始时间、总产程、出血时间、住院时间及出血量明显少于利凡诺引产组(P<0.05);水囊引产组住院时间明显少于药物引产组(P<0.05);水囊引产组及药物引产组产后清宫率明显少于利凡诺引产组(P<0.01);3组引产成功率无明显差异(P>0.05)。水囊引产组恶心、呕吐及发热不良反应明显少于利凡诺引产组及药物引产组(P<0.05);3组宫颈裂伤无显著性差异(P>0.05)。结论水囊引产术是妊娠合并肝功能异常孕妇中期引产可以选择的引产方法。
Objective To investigate the clinical application of water sac in mid-term labor induction in pregnant women with abnormal liver function during pregnancy. Methods Retrospective analysis was performed on the clinical data of 14-27 weeks pregnant women with pregnancy-associated liver dysfunction who were admitted to Shanghai Public Health Clinical Center from June 2014 to June 2016. The patients were divided into induction group (40 cases) , Rivanol intramuscular injection of induction group (40 cases) and mifepristone combined with misoprostol induction group (40 cases), and statistical analysis. Results The onset time of contractions, total labor, bleeding time, length of hospital stay and bleeding volume were significantly less than those in rivaroxurilate induced abortion group (P <0.05). The length of hospitalization in induced abortion group was less than that in induced abortion group (P < 0.05). The rate of postpartum cesarean section in induced abortion group and drug induced abortion group was significantly lower than that of rivanol induced abortion group (P <0.01). There was no significant difference in the success rate of induced abortion among the three groups (P> 0.05). Nausea, vomiting and adverse reactions of induction of fever in induced abortion group were significantly less than those in rivanol induction group and drug induced abortion group (P <0.05). There was no significant difference in cervical laceration among the three groups (P> 0.05). Conclusion Induction of water bag is a method of induction of labor that can be selected during mid-term induction of labor in pregnant women with abnormal liver function during pregnancy.