依沙吖啶联合米非司酮用于瘢痕子宫中期妊娠引产的临床观察

目的:观察依沙吖啶联合米非司酮用于瘢痕子宫中期妊娠引产的效果和安全性。方法:将72例自愿终止妊娠的中期妊娠的瘢痕子宫患者随机均分为对照组和试验组。对照组患者经羊膜腔注入依沙吖啶100 mg;观察组患者在对照组用药基础上同时口服米非司酮50 mg,bid,连服2 d。观察两组患者用药后的宫缩发作时间、引产时间、引产出血量、住院时间,引产成功、胎盘胎膜残留、胎盘粘连、软产道损伤情况及不良反应发生情况。结果:观察组患者的宫缩发作时间、引产时间、引产出血量和住院时间均显著少于对照组,两组比较差异有统计学意义(P<0.05)。两组患者引产成功率比较差异无统计学意义(P>0.05);而在胎盘胎膜残留、胎盘粘连、软产道损伤发生率方面,试验组患者均显著低于对照组,两组比较差异均有统计学意义(P<0.05)。两组不良反应均较轻微,且发生率相同。结论:依沙吖啶联合米非司酮是终止瘢痕子宫中期妊娠的有效方法,可显著缩短患者的宫缩发作时间和引产时间,减少引产出血量,降低软产道损伤等的发生率,临床效果显著,且安全性良好。

Clinical Observation of Ethacridine Combined with Mifepristone for Induced Abortion of Mid-trimester Pregnancy in Patients with Uterine Scar

OBJECTIVE： To observe efficacy and safety of ethacridine combined with mifepristone for induced abortion of mid-trimester pregnancy in patients with uterine scar. METHODS： 72 patients with scarred uterus, who voluntarily terminated mid-trimester pregnancy were randomly divided into control group and experimental group. Control group was given ethacridine 100 mg via amniotic cavity, and observation group was additionally given mifepristone 50 mg, bid, for 2 days on the basis of control group. The time of uterine contraction onset, induction time, abortion bleeding, hospitalization time, the success rate of abortion, retained placenta, placental adhesion, soft birth canal injury and adverse drug reactions were observed in 2 groups after treatment. RESULTS： The time of uterine contraction onset, induction time, abortion bleeding and length of hospitalization stay in observation group were significantly less than in control group; there was statistical significance （P〈0.05）. There was no statistical significance in success rate of induction between 2 groups （P〉0.05） ; while retained placenta, placental adhesion, soft birth canal injury of experimental group were significantly better than those of control group; there was statistical significance between 2 groups （P〈0.05）. The mild adverse drug reactions were observed in 2 groups, and the incidence of adverse drug reactions was same to each other. CONCLUSIONS： Mifepristone combined with ethacridine is an effective method of induced abortion of mid-trimester pregnancy in patients with uterine scar, can significantly shorten the onset time and induction time, reduce abortion bleeding and reduce the incidence of soft birth canal injury with significant clinical effect, and it＇s safety.