摘要
目的 比较经不同引产方案终止中期病理妊娠的临床效果.方法 2015年1月至2016年12月我院共收治92例中期（孕11~16周）病理妊娠孕妇,经不同的中期引产方案终止妊娠.其中29例经米非司酮联合水囊引产（A组）,47例经米非司酮和米索前列腺醇引产（B组）,16例单用利凡诺（C组）.比较引产成功率和引产相关指标（宫缩开始时间、总产程时间、总在院时间、围术期出血量及产后再清宫率、不良事件）.结果 3组引产成功率分别是A组为93.10%（27/29）,B组为100%（47/47）,C组为87.50%（14/16）,3组比较差异有统计学意义（χ2=8.502,P〈0.05）.A组、B组、C组宫缩开始时间分别为（4.61±2.15）、（3.68±2.10）、（5.85±2.30）h,3组比较差异有统计学意义（F=6.05,P=0.025）.A组、B组、C组总产程时间分别为（10.45±3.21）、（7.50±3.40）、（14.60±4.89）h,3组比较差异有统计学意义（F=7.48,P=0.013）.A组、B组、C组总住院时间分别为（4.70±2.33）、（2.80±1.7）、（6.05±2.50）d,3组比较的差异有统计学意义（F=10.23,P=0.011）.A组、B组、C组围术期出血量分别为（64.88±20.50）、（40.10±15.26）、（91.50±31.73）ml,3组比较差异有统计学意义（F=8.70,P=0.020）.产后再清宫率A组为7例（24.10%）,B组为6例（12.80%）,C组为9例（56.30%）,3组比较的差异有统计学意义（χ2=20.40,P=0.003）.不良事件发生率A组为0,B组为0,C组为3例（18.75%）,3组比较差异有统计学意义（χ2=40.00,P〈0.001）.结论 终止病理妊娠宜采用米非司酮联合米索前列腺醇的中期引产方案,其操作简便、安全、有效,在妇产科门诊手术室即可施行.
Objective To compare the clinical effects of different labor induction methods in the termination of intermediate pathological pregnancy. Methods From January 2015 to December 2016,ninety？two cases of intermediate （ 11-16 weeks ） pathological pregnancy were treated in Huangyan Hospital of Wenzhou Medical University. The patients were treated with different intermediate labor induction program to terminate their pregnancy. Among them,29 cases were treated with mifepristone combined with water bag abortion （ group A） ,47 patients with mifepristone and misoprostol induction（ group B） ,16 cases with single rivanol （ group C） . The successful rate of labor induction and the labor induction related indexes （ the onset time of contraction,the total duration of labor,the total amount of bleeding in the hospital,the volume of bleeding in the perioperative period） , the rate of postpartum re？curettage and the adverse events after birth of the two groups were compared. Results The successful rates of labor induction in the three groups were 93. 10% （27/29）,100%（47/47） and 87. 50% （14/16） respectively,the difference among the groups was statistically significant （χ2=8. 502,P〈0. 05）. The onset time in group A was （4. 61±2. 15） h,in group B it was （3. 68±2. 10） h,in group C it was （5. 85±2. 30） h,the difference among the 3 groups was statistically significant （F=6. 05,P =0. 025）. The total duration of labor in group A was （10. 45±3. 21） h,in group B was （7. 50±3. 40） h,in group C was （14. 60±4. 89） h,the difference among the 3 groups was statistically significant （F=7. 48,P =0. 013）. The total hospitalization time in group A was （4. 70 ＋ 2. 33） d,in group B was （2. 80±1. 7） d,in group C was （6. 05±2. 50） d,the difference among the 3 groups was statistically significant （F=10. 23,P =0. 011）. The perioperative bleeding volume in group A,B,C were （64. 88±20. 50） ml,（40. 10±15. 26） ml,（91. 50±31. 73） ml,respectively,the difference was statistically significant （F=8. 70,P=0. 020）. The rate of postpartum re？curettage in group A was 7 cases （24. 10%）,in group B was 6 cases （12. 80%）,in the group C was 9 cases （ 56. 30%） ,the difference was statistically significant （χ2=20. 40,P=0. 003） . The incidence of adverse events in group A and group B were all 0,and in the group C,it was 3 cases （ 18. 75%） ,the difference was statistically significant （χ^2= 40. 00, P〈0. 001 ） . Conclusion The pathological pregnancy should be terminated by induction of mifepristone combined with misoprostol, the operation is simple, safe and effective, and the implementation is feasible in the outpatient operation room of obstetrics and gynecology department.
作者
李文君
王丽萍
吕杰强
Li Wenjun Wang Liping Lyu Jieqiang(Department of Obstetrics and Gynecology, Huangyan Hospital of Wenzhou Medical University, Taizhou 318020, China)
出处
《中国综合临床》
2017年第9期847-850,共4页
Clinical Medicine of China
