依沙吖啶用于瘢痕子宫中期引产的安全性研究  

Research on safety of ethacridine for second-trimester induction of labor in women with a caesarean section scar

作　　者：刘冬[1] 阮洁[1] 黄薇[1] 

机构地区：[1]成都四川大学华西第二医院妇产科,610041

出　　处：《中国妇产科临床杂志》2012年第2期104-107,共4页Chinese Journal of Clinical Obstetrics and Gynecology

摘　　要：目的探讨瘢痕子宫再次妊娠依沙吖啶中期引产的安全性和有效性。方法回顾性分析2008年1月至2011年2月四川大学华西第二医院收治的254例中期妊娠(14～24周)引产患者的临床资料,根据有无剖宫产史分为瘢痕组(82例)和对照组(172例),采用依沙吖啶经腹羊膜腔内注射(或配伍米非司酮)引产,观察两组的宫缩发动时间、排胎时间及阴道出血量、胎盘胎膜残留等并发症。结果瘢痕组引产成功率为96.34%(79/82),对照组引产成功率为98.26%(169/172);两组排胎时间、阴道出血量、胎盘胎膜残留率比较,差异均无统计学意义(P>0.05),但瘢痕组宫缩发动时间[(32.55±9.61)h]明显短于对照组[(33.87±15.35)h;P<0.01];瘢痕组中依沙吖啶配伍米非司酮组排胎时间[(38.96±13.37)h]明显短于单用依沙吖啶组[(47.71±14.40)h;P<0.01]。结论依沙吖啶经腹羊膜腔内注射用于瘢痕子宫中期妊娠引产是一种安全有效的方法;若同时配伍米非司酮,可以加快产程进展,提高引产效率。Objective To evaluate the safety and efficacy of ethacridine for mid-trimester pregnancy induction in women with a scarred uterus.Methods 254 women who underwent second trimester（14~24 gestational weeks） termination of pregnancy in West China Second University Hospital during January 2008 to February 2011 were enrolled in this study.82 women with a uterine scar（group A）were compared with 172 patients without scarred uterus（group B）.Intraamniotic injection of ethacridine was applied in both groups,supplemented with or without mifepristone.Results The two groups were similar for general conditions.The success ratio was 96.34%（79/82） in group A and 98.26%（169/172） in group B.The mean time from induction to abortion,the volume of blood loss,retained placenta or membrane and the complication rate were similar in both groups.But the activation time was much shorter in group A [（32.55±9.61）h]than that in group B[（33.87±15.35）h;P0.01].In group A,for the patients inducted by ethacridine combined with mifepristone,the time from induction to abortion[（38.96±13.37） h]was significantly shorter than ethacridine[（47.71±14.40）h;P0.01].Conclusions Transamniotic injection of ethacridine is a safe and effective method for abortion in women with a prior caesarean section.And the combination of mifepristone will significantly shorten the duration of labor.

关 键 词：瘢痕子宫 中期妊娠 引产 依沙吖啶 米非司酮 

分 类 号：R719.3[医药卫生—妇产科学]