控釋地諾前列酮栓用于足月妊娠引產的評價

摘 要 目的:探討控釋地諾前列酮栓用于足月妊娠引產的臨床效果與安全性。方法:對2009年1月～2010年3月250例應用控釋前列酮栓與220例使用縮宮素引產的病例進行回顧性分析。結果:①試驗組用藥4小時、6小時及12小時后平均宮頸Bishop評分5.72±1.12，7.22±1.45分，7.81±1.73分，而對照組分別為4.42±1.14分，5.07±1.78分，5.4±1.62分，差異有顯著性(P<0.05)。②試驗組的第一產程、第二產程及總產程短于對照組，差異有統計學意義(P<0.05);對照組用藥后至規律宮縮明顯短于觀察組，差異有統計學意義(P<0.05)。③研究組24小時引產成功率68%，失敗率12%，對照組平均24小時引產成功率51%，失敗率20%，差異有顯著性(P<0.05)。④兩組分娩方式與剖宮產指征無統計學差異。兩組產后出血量、新生兒體重、新生兒Apgar評分、新生兒窒息發生率差異無顯著性(P>0.05)。⑤控釋地諾前列酮栓的不良反應為子宮過度刺激，發生率1.6%。結論:與催產素相比，控釋地諾前列酮栓促宮頸成熟作用顯著，引產成功率高、特別適于宮頸Bishop評分低者使用，且不增加胎兒窘迫發生率及手術產率，也不增加新生兒窒息及產褥感染率，是有效、安全的。

關鍵詞 地諾前列酮 宮頸成熟 妊娠

doi:10.3969/j.issn.1007-614x.2010.22.089

AbstractObjective:To explore the efficacy and safety of controlled-released dinoprostoneused in term pregnancies induction.Methods:250 cases used Controlled-release dinoprostone and 220 cases used oxytocin for labour induction between Jan，2009 to Mar，2010 were recorded and investigated.Results:①The Bishop score 4 hours，6 hours and 12 hours after medication was 5.72±1.12，7.22±1.45，7.81±1.73 in study group，while it was 4.42±1.14，5.07±1.78，5.4±1.62 in control group.There were differences between two groups(P<0.05).②The lengths of the first stage，the scend stage and the total stage of labour in study group were shorter than those in control group.The average time of using drug to beginning contraction in study group was longer than that in control group.There were significant differeces between two groups(P<0.05);③The achievement ratio in 24 hours and the defeat ratio in study group was 68% and 12%，while that in control group was 51%，and 20%，There were significant differeces between two groups(P<0.05).④There was no difference in delivery type ，operation index，incidence of fetal distress and post-partum haemorrhage or infection.⑤The chief side effect of controlled-released dinoprostone was hyperstimulation on uterus and the incidence was 1.6%.Conclusions:Controlled-release dinoprostone was more effective than oxytocin in cevical ripening for medical induction in term pregnancies，especially in the low Bishop score cases.Controlled-release dinoprostone does not induce adverse maternal or fetal morbidity.

Key WordsControlled-release dinoprostone;cervical ripening;labor induction