控释地诺前列酮栓用于促宫颈成熟的临床研究

目的探讨控释地诺前列酮栓用于促宫颈成熟的撤药时间。方法选择于2009年6月至2013年8月在广州市中西医结合医院使用地诺前列酮栓进行引产的产妇46例。其中观察组20例,药物的撤药时机为宫颈评分达6分;对照组26例,撤药时机为临产。记录两组产妇的药物平均放置时间、总产程、分娩方式及新生儿情况,胎监异常和羊水粪染及其他不良反应。结果观察组药物放置时间为（7.30±2.39）h,对照组为（9.85±5.74）h,两组比较差异有统计学意义（P〈0.05）;观察组总产程为（11.1±6.4）h,对照组为（9.1±5.3）h,观察组总产程明显延长,差异有统计学意义（P〈0.05）。因产程缩短,对照组出现5例急产,而观察组无急产发生;观察组阴道分娩率为80.0%,剖宫产分娩率为20.0%,对照组阴道分娩率为69.2%,剖宫产分娩率为30.8%,两组比较差异均无统计学意义（P〉0.05）;两组羊水和胎心监护异常发生率及新生儿窒息发生率差异无统计学意义（P〉0.05）。结论控释地诺前列酮栓的撤药时机定义为宫颈评分达到6分相对于临产容易掌握,能减少急产的发生机会从而更加安全。

The clinical observation of control-release dinoprostone vaginal suppository promotes cervical ripening

Objective To investigate the withdrawal time of dinoprostone suppositories（0.8 mm）used in cervical ripening in women. Methods 46 cases using dinoprostone suppositories to induced labor in Guangzhou hospital of Integrated Traditional and Western Medicine from June 2009 to August 2013 were enrolled for this study.There were 20 cases in the observation group which set the withdrawal time for cervical scores six points,and 26 cases in the control group which set the withdrawal time at labor. The average inserted time of dinoprostone suppository,mode of delivery,total time of labor,fetal heart beat,neonatal situation,abnormal fetal monitor and amniotic fluid with dung and other adverse reactions were recorded. Results Inserted time of dinoprostone suppository in test group was significantly shorter than the control group[（7.30±2.39）hours vs（9.85±5.74）hours Cesarean delivery,P〈0.05]. The total labor time in test group was significantly longer than control group [test group was（11.13 ±3.04）hours,control group was（8.27 ±3.37）hours,P 〈0.05]. There were 5 cases precipitate labor in control group,but none in test group.The rate of vaginal delivery was 80% and the rate of cesarean delivery was 20% in test group. In the control group,the rate of vaginal delivery was 69.2% and the rate of cesarean delivery was 30.8%. There were no significant differences on the mode of delivery between two groups（P〉0.05）.It had no significant difference in the rate of abnormal amniotic fluid and cardiac care and the rate of neonatal asphyxia between two groups（P 〉0.05）. Conclusion The withdrawal time set at the cervical score of six points is easier to monitor and can reduces the precipitate labor,abnormal amniotic fluid and cardiac care.