王怡 冯丽晶

[摘要] 目的 评价小剂量米索前列腺醇在足月妊娠引产中的应用效果。 方法 选取2014年10月～2015年10月在北京市第一中西医结合医院分娩的孕足月、单胎头位、无引产及用药禁忌证的孕妇220例作为研究对象。随机分为两组：观察组110例，予以小剂量米索前列腺醇（25 μg）引产；对照组110例，予以缩宫素引产。观察两组孕妇用药前后宫颈Bishop评分、引产成功率、剖宫产率、妊娠结局及不良反应发生等情况。 结果 观察组剖宫产率低于对照组，差异有统计学意义（P < 0.05）；观察组引产总有效率、引产成功率、用药到临产时间均优于对照组，差异均有统计学意义（P < 0.05）。 结论 小剂量米索前列腺醇用于足月妊娠引产，是一种安全有效、经济的方法，同时可降低剖宫产率，值得基层医院推广。

[关键词] 小剂量；米索前列腺醇；引产；剖宫产率

[中图分类号] R714.21 [文献标识码] A [文章编号] 1673-7210（2016）02（b）-0103-04

Effect assessment of low dose of Misoprostol application in induced labor of full-term pregnancy

WANG Yi FENG Lijing

Department of Obstetrics and Gynecology， Beijing First Hospital of Integrated Chinese and Western Medicine， Beijing 100018， China

[Abstract] Objective To evaluate the effect of low dose Misoprostol on induced labor of full-term pregnant women. Methods 220 cases of full-term， singleton pregnant， no contraindications in induced labor and medical women from October 2014 to October 2015 in Beijing First Hospital of Integrated Chinese and Western Medcine were selected. All subjects were divided into two groups： 110 cases in the control group was given oxytocin； 110 cases in the observation was given Misoprostol （25 μg）. Bishop score of cervical before and after medication， rate of successful induced labor and cesarean section rate， pregnancy outcome and adverse reactions of two groups were observed. Results Cesarean section rate of the observation group was lower than that of the control group， the difference was statistically significant （P < 0.05）； total effective rate of induced labor， rate of success induced labor， time of medications to the labor of the observation group were significantly better than those of the control group， the differences were statistically significant （P < 0.05）. Conclusion Low dose Misoprostol is a safe， effective and economic method， and reduce cesarean section rate in induced labor of full-term pregnant women， should be popularized in basic-level hospitals.

[Key words] Low dose； Misoprostol； Induced labor； Cesarean section rate

晚期孕婦适时引产，是临床上有效降低母婴患病率、保护母婴安全的常用方法，也是高危产科普遍采用的方法。如果引产方法不当，必将危害母婴健康，尤其是增加胎儿宫内窘迫及剖宫产的发生率，因此选择正确的引产方法尤为重要。引产成功与否的关键在于宫颈的成熟度，临床上长期使用催产素作为引产药物，但对于宫颈不成熟的孕妇引产效果欠佳，引产时间长，且剖宫产率高。近年来，临床上开始使用控释性前列腺素E2栓（商品名：普贝生），用于促宫颈成熟和引产，但因其价格偏高，基层医院的产科难以推广。而最近，小剂量米索前列醇的适当引产引起了学者的广泛关注。该药物经阴道给药，用于Bishop宫颈成熟度评分值低（≤6 分）的孕妇引产，不仅价格低廉，安全性好，且引产效果显著。北京市第一中西医结合医院（以下简称……