普贝生用于延期妊娠引产的临床研究(1)
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【摘要】目的 探讨普贝生用于延期妊娠引产的疗效。方法 将孕41周～41+6周、单胎、头位、未破膜的初产妇80例，随机分为研究组和对照组各40例，研究组阴道后穹窿放置普贝生1枚，对照组微量泵应用催产素。观察并记录用药后6小时宫颈评分改善情况、用药至临产所需时间、用药至分娩所需时间、24h引产成功率、胎儿、羊水情况。结果 两组宫颈评分改善情况、引产成功率、临产和分娩所需时间比较差异均有统计学意义(P<0.05)；而胎心异常和羊水粪染等方面无统计学差异(P>0.05)。结论 普贝生相对于催产素用于延期妊娠引产更省时、成功率更高，且不增加分娩风险。
【关键词】普贝生 催产素 延期妊娠
中图分类号：R714.21 文献标识码：B 文章编号：1005-0515(2011)10-238-03
Clinical evaluation of Propess for induction in Prolong Pregnancy
ZHANG XiaofengCHEN Jinguo YE Ping
(Department of Obstetrics by The city Hospital of Ningde，Fu-jian Province，Ningde 352100，China)
【Abstract】Objective To explore the effect of propess for the extension of labor induction.Methods The prepess was used in 40 cases as study group, the oxytocin was used in 40 cases as control group.All the pregnant women were single tire,and have not rupture of membranes, 41- 41+6 weeks.They were randomly divided into propess group and oxytocin group. The cervical score,24h induction success rate,time to labor,cesarean section rate,fetal amniotic fluid was observed and compared.Results The propess could effectively and safely promote cervical ripening and increase the success rate of labor induction, which had short time-consuming, lower damage, and was more convenient and easier to be accepted by pregnant women and their families.There was not significant difference between 2 groups for fetal distress rate, postpartum hemorrhage rate.Conclusion Compared to the control group，the propess group had a higher success rate，and can reduce the cesarean section rate.
【Key words】propess oxytocin prolong pregnancy
延期时胎盘停止生长并出现退行性变化，造成羊水量减少，胎儿容易出现宫内窘迫[1],临床也常见延期妊娠孕妇复查彩超提示羊水指数下降、羊水浑浊、大脑中动脉、脐动脉血流指数变化，胎心监测评分较低，甚至无反应型，孕妇自觉胎动减少等情况，因此，有必要积极干预，予以引产适时终止妊娠。宫颈成熟情况是决定引产成功与否的一个重要因素，宫颈Bishop评分高低与引产成功率有关，临床常用前列腺素及其类似物进行引产[2]。本研究使用的普贝生是一种控释、可回复的地诺前列酮(前列腺素E2,PGE2 )阴道栓剂，适用于妊娠晚期宫颈评分低者促宫颈成熟和引产[3]。本文总结分析了40例宫颈未成熟低评分的足月头位妊娠孕妇采用普贝生促宫颈成熟引产的效果，并与40例用小剂量天然催产素引产的足月头位妊娠孕妇进行比较，现报道如下：
1 资料与方法
1.1 研究对象
选取2011年1月至7月就诊我院产科分娩的孕妇80例，孕周根据月经史及早孕B超经核对后均为41周-41+6周，随机分为研究组和对照组,每组40例。研究组平均
年龄(24.2±3.7)岁；对照组平均年龄(27.9±4.0)岁；两组年龄无统计学差异，具有可比性。所有病例均为单胎、头位、胎膜完整，血常规、凝血功能、肝肾功能无异常，无阴道分娩禁忌证，阴道检查宫颈Bishop评分≤5分,骨盆内、外测量无异常，未临产，胎心监测为反应型，无哮喘及青光眼，无严重合并症，胎儿生物物理评分良好。用药前均签署知情同意书。
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