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目的评价并分析欣普贝生(药品名地诺前列酮栓)应用于足月胎膜早破促宫颈成熟的效果及安全性。方法选择2010年1～12月住院有引产指征的足月妊娠孕妇321例,随机分成3组,其中A组(研究组)107例为胎膜早破,B组(对照组1)未破膜107例,C组(对照组2)107例为胎膜早破。A组与B组均使用欣普贝生引产,C组使用缩宫素引产。分别比较A组与B组及C组的引产效果及妊娠结局。结果 3组用药前宫颈Bishop评分均无统计学差异,A组用药后宫颈Bishop评分均高于B组和C组(P﹤0.01)。A组、B组、C组用药24h促宫颈成熟有效率分别是99.1%、94.0%、90.7%,胎膜早破使用欣普贝生组促宫颈成熟有效率明显高于使用缩宫素组,差异有统计学意义(P﹤0.05);B组、C组剖宫产率(分别为27.1%、23.9%)均高于A组(11.2%)(P﹤0.05);A组用药至临产时间、潜伏期时间及活跃期时间均短于B组及C组(P﹤0.05)。A组产后出血、胎儿窘迫、新生儿窒息等发生情况与B组、C组比较差异无统计学意义(P﹥0.05)。结论欣普贝生应用于足月妊娠促宫颈成熟引产是安全有效的,欣普贝生用于足月胎膜早破孕妇促宫颈成熟及诱发宫缩的作用较催产素效果更佳,且较胎膜完整孕妇起效更快,也减少了剖宫产率。
Objective To evaluate and analyze the effect and safety of Hinbu Beishen (drug name dinoprostone suppository) in cervical ripening induced by full-term premature rupture of membranes. Methods A total of 321 full-term pregnant women with indications for induction of labor in hospital from January to December 2010 were randomly divided into 3 groups, 107 of which were group A (study group), and 1 group of group B (control group 1) were unbroken 107 cases of membrane, group C (control group 2) 107 cases of premature rupture of membranes. Group A and group B were using Yan Popei induced abortion, group C using oxytocin abortion. The effects of induction of labor and pregnancy outcomes were compared between group A, group B and group C, respectively. Results The Bishop scores of cervical before treatment were not significantly different in all three groups. The Bishop score of cervical in group A was higher than those in groups B and C (P <0.01). The effective rates of cervical ripening in group A, group B and group C were 99.1%, 94.0% and 90.7%, respectively. The effective rate of cervical ripening in patients with premature rupture of membranes was significantly higher than that in oxytocin group, (P <0.05). The rate of cesarean section in group B and group C (27.1% and 23.9%, respectively) was significantly higher than that in group A (11.2%) (P <0.05) , Latency time and active period were shorter than those in group B and group C (P <0.05). The incidence of postpartum hemorrhage, fetal distress and neonatal asphyxia in group A were not significantly different from those in group B and group C (P> 0.05). Conclusions The application of Enopbei to full-term pregnancy and cervical ripening induction of labor is safe and effective, and the effect of Enpisiben on pregnant women with full-term premature rupture of membranes in promoting cervical ripening and contractions is better than that of oxytocin Fetal membranes complete maternal effect faster, but also reduce the cesarean section rate.