靳紫薇 张海燕 谢玲

[摘要] 目的 探討盐酸利托君与硫酸镁联合治疗早产胎膜早破患者的临床疗效。 方法 本文选择我院2017年3月～2018年3月收治的291例患者，随机分为观察组（n=146）和对照组（n=145）。对照组采用硫酸镁治疗，观察组在对照组的基础上联合盐酸利托君治疗。比较两组临床疗效、宫缩抑制时间、延长妊娠时间及妊娠方式。结果 观察组总有效率为91.78%，高于对照组84.83%，但两组差异无统计学意义（χ2=3.409，P=0.065）;两组整体疗效比较，观察组优于对照组（Z=-8.248，P=0.000）。观察组宫缩抑制时间与对照组比较显著降低，而延长妊娠时间显著延长，差异有统计学意义（t=-12.481，P=0.000;t=4.285，P=0.000）。治疗后，两组SF-36评分与治疗前比较均显著升高，差异有统计学意义（t=9.119，P=0.000;t=7.653，P=0.000）。且治疗后观察组SF-36评分为（83.52±21.28）分，显著高于对照组的（78.33±17.67）分，差异有统计学意义（t=2.264，P=0.024）。观察组的自然分娩比例与对照组比较显著升高，而剖宫产比例显著降低，差异有统计学意义（χ2=12.398，P=0.000）。 结论 盐酸利托君与硫酸镁联合治疗PPROM临床疗效显著，可有效缩短宫缩抑制时间，延长患者孕周，降低剖宫产率，改善生活质量及妊娠结局，安全性高，值得推广应用。

[关键词] 早产胎膜早破;盐酸利托君;硫酸镁;宫缩抑制;妊娠结局

[中图分类号] R714.4          [文献标识码] B          [文章编号] 1673-9701（2020）17-0065-04

Clinical effect of ritodrine hydrochloride combined with magnesium sulfate in the treatment of 146 cases of premature rupture of membranes

JIN Ziwei   ZHANG Haiyan   XIE Ling

Department of Gynecology， Qinghai Red Cross Hospital， Xining   810002， China

[Abstract] Objective To investigate the clinical efficacy of ritodrine hydrochloride combined with magnesium sulfate in the treatment of premature rupture of membranes. Methods A total of 291 patients admitted in our hospital from March 2017 to March 2018 were randomLy divided into observation group（n=146） and control group（n=145）. The control group was treated with magnesium sulfate， and the observation group was treated with ritodrine hydrochloride based on the treatment of the control group. The clinical efficacy， time of uterine contraction inhibition， prolonged pregnancy time and pregnancy mode between two groups were observed and compared. Results The total effective rate was 91.78% in the observation group， higher than 84.83% in the control group. There was no significant difference between the two groups（χ2=3.409， P=0.065）. The overall efficacy in the observation group was superior to that of the control group（Z= -8.248， P=0.000）. The inhibition time of the uterine contraction in the observation group was significantly lower than that in the control group， and the prolonged pregnancy time in the observation group was significantly prolonged， and the difference was statistically significant（t=-12.481， P=0.000; t=4.285， P=0.000）. After treatment， the SF-36 scores of the two groups were significantly higher than those before treatment， and the difference was statistically significant（t=9.119， P=0.000; t=7.653， P=0.000）. The SF-36 scores of the observation group were（83.52±21.28） after treatment，which were significantly higher than those of the control group（78.33±17.67），and the difference was statistically significant（t=2.264， P=0.024）. The proportion of natural delivery in the observation group was significantly higher than that in the control group， while the proportion of cesarean section in the observation group was significantly lower， and the difference was statistically significant（χ2=12.398， P=0.000）. Conclusion The combination of ritodrine hydrochloride and magnesium sulfate in the treatment of PPROM has a significant clinical effect， which can effectively shorten the time of contraction inhibition， prolong the gestational age， reduce the cesarean section rate， improve the quality of life and pregnancy outcome， and have high safety. It is worthy of popularization and application.

[Key words] Premature rupture of membranes; Ritodrine hydrochloride; Magnesium sulfate; Uterine contraction inhibition; Pregnancy outcome

早产胎膜早破（premature preterm rupture of membranes，PPROM）属于妊娠晚期严重的并发症之一，指妊娠28～37周之间因为自发性胎膜早破导致的早产[1]。临床研究认为，PPROM的发生多与感染、胎位异常、宫颈机能不全等因素密切相关，发病率约为4%左右[2]。PPROM可导致产妇宫内感染，胎儿呼吸窘迫、畸形甚至死胎的风险明显增加，严重威胁母婴生命健康安全，成为导致围产儿死亡的主要原因[3]。……