妊娠高血压孕妇口服米索前列醇联合阴道放置单硝酸异山梨酯的分娩情况:一项RCT研究  

Oral misoprostol and vaginal isosorbide mononitrate for induction of labor in pregnant women with hypertension:a randomized controlled trial study

作　　者：张秀玲 贾小文 张嵘 李慧娟 南海琼 郭利佩 Zhang Xiuling;Jia Xiaowen;Zhang Rong;Li Huijuan;Nan Haiqiong;Guo Lipei(Department of Obstetrics and Gynecology,Xi′an XD Group Hospital,Xi′an 710077,China)

机构地区：[1]西电集团医院妇产科,陕西西安710077

出　　处：《实用药物与临床》2022年第10期884-887,共4页Practical Pharmacy and Clinical Remedies

基　　金：西安市卫生健康委员会科研项目(2020yb87)。

摘　　要：目的 探讨在妊娠高血压孕妇中,口服米索前列醇联合阴道放置单硝酸异山梨酯与口服米索前列醇在宫缩过频、剖宫产率及阴道分娩时间方面的效果。方法 收集2020年4月至2021年3月在西电集团医院妇产科收治的妊娠晚期高血压疾病患者,按照随机数法将符合条件的妊娠高血压孕妇以1∶1的比例随机分配到联合组(口服米索前列醇联合阴道放置单硝酸异山梨酯)或单药组(口服米索前列醇)。主要结局指标是宫缩过频及剖宫产率,次要结局指标为治疗后12 h Bishop评分及阴道分娩时间。结果 本研究最终纳入140例妊娠期高血压孕妇,其中联合组69例,单药组71例。与单药组相比,联合组宫缩过频的频率降低(OR=0.388,95%CI:0.169~0.891,P=0.026)。同时,联合组剖宫产率显著低于单药组(OR=0.391,95%CI:0.175~0.873,P=0.022)。单药组分娩时间显著长于联合组[(10.1±3.0)h vs.(9.3±1.5)h],差异具有统计学意义(P<0.001)。两组治疗后12 h Bishop评分差异无统计学意义(P=0.711)。结论 在接受引产的妊娠高血压孕妇中,与口服单药米索前列醇相比,米索前列醇和单硝酸异山梨酯联用可减少宫缩过频的频率,降低剖宫产率并减少分娩时间。Objective To compare the efficacy of oral misoprostol combined with vaginal placement of isosorbide mononitrate with that of oral misoprostol on the over-contractions,cesarean section rate and time interval to vaginal delivery in pregnant women with hypertension.Methods In this randomized controlled trial,we collected eligible pregnant women with hypertension who were admitted to Department of Obstetrics and Gynecology in Xi′an XD Group Hospital between April 2020 and March 2021.They were randomly assigned to the combination group(oral misoprostol combined with vaginal placement of isosorbide mononitrate to induce labor) or the monotherapy group at a ratio of 1∶1 according to the random number method.Primary outcomes included the frequency of contractions and the cesarean section rate,and the secondary outcomes included Bishop score 12 hours after treatment and vaginal delivery time.Results Totally 140 cases were selected,including 69 in combination group and 71 in monotherapy group.Rates of uterine hyperstimulation and cesarean section were lower in combination group than in monotherapy group(OR=0.388,95%CI:0.169~0.891,P=0.026;OR=0.391,95%CI:0.175~0.873,P=0.022,respectively).Meanwhile,vaginal birth time was longer in women in combination group [(10.1±3.0)h]than in monotherapy group [(9.3±1.5)h](P<0.001).However,12 h Bishop score did not differ significantly between the two groups(P=0.711).Conclusion Compared with oral misoprostol for induction of labor,oral misoprostol combined with vaginal isosorbide mononitrate can reduce the rates of contractions and cesarean section and shorten the time to vaginal delivery.

关 键 词：妊娠高血压 米索前列醇 单硝酸异山梨酯 引产 

分 类 号：R714.246[医药卫生—妇产科学]