目的 探討依沙吖啶聯(lián)合米非司酮在中期妊娠引產(chǎn)治療中的臨床療效。方法 選取鄭州大學第三附屬醫(yī)院2015年1月-2019年6月產(chǎn)科220例中期妊娠引產(chǎn)患者為研究對象。根據(jù)治療方法將患者分為對照組（80例）和觀察組（140例）。對照組先口服米非司酮片，50 mg/次，2次/d，連續(xù)服用2 d后將米索前列醇片置于陰道穹窿處，妊娠24周以內(nèi)400 μg/次，3 h重復，但不超過1.8 mg；妊娠24周以上200 μg/次，6 h可重復，每日給藥不超過4次。觀察組患者口服米非司酮片（用法同對照組）后1 h采用7號穿刺針于下腹正中、宮底下兩三橫指下方腹中線上進行羊膜腔穿刺，注入100 mg乳酸依沙吖啶注射液。比較兩組患者的引產(chǎn)效果、手術情況、疼痛程度、月經(jīng)恢復以及不良反應發(fā)生情況。結果 治療后，觀察組患者引產(chǎn)成功率與清宮率分別為98.57%與19.29%，對照組患者引產(chǎn)成功率與清宮率分別為85.00%與35.00%，兩組比較存在統(tǒng)計學差異（P<0.05）。與對照組相比，觀察組患者的產(chǎn)后2 h出血量、用藥至規(guī)律宮縮時間、規(guī)律宮縮至胎兒娩出時間、產(chǎn)后出血時間及胎盤殘留率更少（P<0.05）。治療后，觀察組患者1分疼痛的比率顯著高于對照組（P<0.05）。兩組患者月經(jīng)復潮時間及經(jīng)期持續(xù)時間比較無統(tǒng)計學差異。治療期間，觀察組和對照組不良反應發(fā)生率分別為8.57%、17.50%，兩組比較無統(tǒng)計學差異。結論 依沙吖啶聯(lián)合米非司酮可有效提高引產(chǎn)效果，引產(chǎn)時間短，產(chǎn)后恢復快，安全性高，在中期妊娠引產(chǎn)患者中具有較高的應用價值。

Objective To investigate the efficacy of ethacridine combined with mifepristone in treatment of midtrimester induction of labor. Methods Patients (220 cases) with midtrimester induction of labor in the Third Affiliated Hospital of Zhengzhou University from January 2015 to June 2019 were divided into control group (n=80) and observation group (n=140) according to the treatment method. Patients in the control group was po administered with Mifepristone Tablets, 50 mg/time, twice daily. After continuous administration of Mifepristone Tablets for 2 days, Misoprostol Tablets were placed on the vaginal fornix. Patients within 24 weeks of pregnancy were treated for 400 μg/time, 3 hours of repetition, but not more than 1.8 mg, Patients more than 24 weeks of pregnancy were 200 μg/time for 6 hours of repetition, no more than four times daily. Patients in the observation group were po administered with Mifepristone Tablets (the same as the control group). After1 hour of oral administration, amniocentesis was performed with no. 7 needle in the middle of the lower abdomen and the abdominal midline below the two or three fingers of the uterus, and injected with 100 mg Ethacridine Lactate Injection. The induced labor effect, operation condition, pain severity, menstrual recovery, and adverse reactions in two groups were compared. Results After treatment, the success rate of induced labor and the rate of curettage were 98.57% and 19.29% in the observation group, and 85.00% and 35.00% in the control group, respectively, there was statistical difference between the two groups (P<0.05). Compared with the control group, patients in the observation group had less bleeding volume in 2 h after delivery, the time from administration to regular uterine contraction, time from regular uterine contraction to fetal delivery, time of postpartum hemorrhage, and placenta residual rate (P<0.05). After treatment, the rate of 1 point pain in the observation group was significantly higher than that in the control group (P<0.05). There was no significant difference in the menstruation time and duration of menarche between two groups. During the treatment, the incidence of adverse reactions in the observation group and the control group were 8.57% and 17.50% respectively, there was no statistical difference between two groups. Conclusion Ethacridine combined with mifepristone can effectively improve the effect of induced labor, with short induced labor time, rapid recovery after childbirth, high safety, and high application value in the patients with midtrimester induction of labor.

R984

河南省醫(yī)學科技攻關計劃項目（201403110）