陈艳　言齐　黄敏嫦

【摘要】 目的 观察联合米非司酮及乳酸依沙吖啶注射液（利凡诺）对疤痕子宫患者中期妊娠引产的疗效。方法 80例疤痕子宫中期引产的患者， 随机分为对照组及实验组， 各40 例。对照组采用利凡诺引产， 实验组在对照组基础上联合米非司酮引产， 比较两组引产总时间、宫缩发动时间、宫缩至流产结束时间及流产后有效率及出血量。结果 对照组的宫缩至流产结束时间与实验组比较差异无统计学意义（P>0.05）；实验组引产总时间和宫缩发动时间少于对照组（P<0.05）。实验组有效率为100.0%， 高于对照组的87.5%（P<0.05）。实验组流产后出血量为（71.49±31.45）ml， 少于对照组的（99.38±33.79）ml， 差异有统计学意义（P<0.01）。结论 米非司酮联合利凡诺引产对于疤痕子宫中期妊娠引产患者的疗效可靠， 方法简便易行、出血量少、有效率及安全性高， 并有利于缩短引产时间及产程进展。

【关键词】 米非司酮；乳酸依沙吖啶注射液；疤痕子宫；中期妊娠

DOI：10.14163/j.cnki.11-5547/r.2016.31.019

【Abstract】 Objective To observe curative effect by mifepristone combined with ethacridine lactate injection （rivanol） for induced labor in scarred uterus midtrimester pregnancy. Methods A total of 80 patients receiving induced labor in scarred uterus midtrimester pregnancy were rando mly divided into control group and experimental group， with 40 cases in each group. The control group received rivanol for induced labor， and the experimental group received additional mifepristone for induced labor. Comparison was made on total time of induced labor， uterine contraction start time， duration between uterine contraction and abortion， effective rate and bleeding volume after abortion between the two groups. Results There was no statistically significant difference of duration between uterine contraction and abortion between the control group and the experimental group （P>0.05）. The experimental group had shorter total time of induced labor and uterine contraction start time than the control group （P<0.05）. The experimental group had higher effective rate as 100.0% than 87.5% in the control group （P<0.05）. The experimental group had fewer bleeding volume after abortion as （71.49±31.45） ml than （99.38±33.79） ml of the control group， and the difference had statistical significance （P<0.01）. Conclusion Combination of mifepristone and rivanol shows creditable effect for induced labor in scarred uterus midtrimester pregnancy. This method is easily operated， along with few bleeding volume and high effective rate and safety. It is beneficial for shortening induced labor time and progress.

【Key words】 Mifepristone； Ethacridine lactate injection； Scarred uterus； Midtrimester pregnancy

目前， 我国由于医疗观念的改变和诊疗技术的进步， 剖宫产病例增多， 剖宮产率较高， 因此疤痕子宫意外妊娠需终止妊娠的病例明显增加[1]。临床终止妊娠的主要方式有手术及药物流产[2]。利凡诺羊膜腔内注射引产为目前临床上常用的中期妊娠引产方法， 但利凡诺极易出现宫缩强直、宫颈破裂甚至子宫破裂， 其原因有疤痕子宫本身比较薄弱， 中期妊娠孕妇宫颈成熟度不够， 其所引发的宫缩不是子宫自发性收缩等原因[3]。本院联合米非司酮及利凡诺用于疤痕子宫患者中期妊娠引产， 有效率性及安全性高， 出血量少， 并有利于缩短引产时间及产程进展。现报告如下。

1 资料与方法

1. 1 一般资料 选取2014年7 月～2016 年6月在本院接受疤痕子宫中期引产的患者80例。纳入标准：①孕妇年龄20～40岁， 妊娠18～24周； ②患者无妊娠并发症或合并症； ③胎儿双顶径均由B超测定>35 mm；④患……