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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。
Objective To investigate the controlled release norethisterone suppository for the promotion of cervical ripening withdrawal time. Methods From June 2009 to August 2013 in Guangzhou City Hospital of Traditional Chinese and Western use of dinoprostone plug abortion 46 cases of maternal labor. The observation group of 20 cases, the timing of drug withdrawal for the cervical score of 6 points; control group of 26 patients, withdrawal time for labor. Record the average placement time of the two groups of maternal drugs, total labor, mode of delivery and neonatal conditions, fetal monitoring abnormalities and amniotic fluid meconium and other adverse reactions. Results The duration of drug release was (7.30 ± 2.39) h in the observation group and (9.85 ± 5.74) h in the control group, with a significant difference between the two groups (P <0.05). The total duration of labor in the observation group was (11.1 ± 6.4) The control group (9.1 ± 5.3) h, the observation group, the total prolonged labor, the difference was statistically significant (P <0.05). Due to the shortening of labor, the control group, 5 cases of acute birth, while the observation group no emergency occurred; observation group vaginal delivery rate was 80.0%, cesarean section delivery rate was 20.0%, control group vaginal delivery rate was 69.2%, cesarean section The rate of childbirth was 30.8%. There was no significant difference between the two groups (P> 0.05). There was no significant difference in the incidence of abnormal amniotic fluid and fetal heart rate monitoring and neonatal asphyxia between the two groups (P> 0.05). Conclusions The timing of the withdrawal of controlled release dinoprost suppository is defined as a cervical score of 6 points which is easier to grasp than that of childbirth and can reduce the chance of emergencies and thus make it safer.