小剂量米索前列醇联合人工破膜用于足月妊娠引产60例临床护理(1)
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摘 要 目的：探讨阴道后穹隆小剂量米索前列醇(简称米索) 联合人工破膜促宫颈成熟用于足月妊娠引产的有效性和安全性。方法：将180例产妇按住院号随机分为三组各60例。A组阴道后穹隆小剂量米索25 μg每4 h 1次直至出现规律宫缩，每日最大量100 μg，4 h后进行宫颈评分行人工破膜；B组直接口服米索25 μg每4 h 1次至规律宫缩作为对照组；C组行静脉滴注缩宫素引产。观察各组宫颈成熟情况及产程。结果：A组从首次用药至临产时间及总产程时间较B组、C组缩短(P<0.01)。A组米索用量少于B组(P<0.01)。三组产后出血及新生儿情况比较差异无统计学意义(P>0.05)。结论：阴道后穹隆小剂量米索联合人工破膜促宫颈成熟用于足月妊娠引产，两者促宫颈成熟、促发宫缩及促宫口扩张作用同步，能在短时间内发动及结束分娩，是一种安全有效的引产方法。
关键词 米索前列醇；足月妊娠；引产；人工破膜；宫颈成熟
中图分类号：R473.71 文献标识码：A 文章编号：1006-7256(2011)15-0020-03
Clinical nursing care of 60 cases in the induced labor of term pregnancy with small dose of
Misoprostol combined with artificial rupture of membranes
Pi Gui-ling, Chen Dian-hong, Chen Xiu-jun
(The Second People's Hospital of Liaocheng Municipality Affiliated to Taishan Medical College, Linqing Shandong 252601, China)
Abstract Objective: To study the effectiveness and safety of small dose of Misoprostol via posterior fornix combined with artificial rupture of membranes in the induced labor of term pregnancy. Methods: 180 parturient women were randomly divided into 3 groups according to the sequence number of admission (60 cases for each group). The parturient women in the group A were given small dose of 25μg Misoprostol via posterior fornix one time every 4 hours until the emergence of regular contraction, the maximum of Misoprostol each day was 100μg. And then artificial rupture of membranes was performed 4 hours later according to the cervical score; 25μg Misoprostol was given to the parturient women orally once every 4 hours till the emergence of regular contraction in the group B; Oxytocin was intravenously given to the parturient women for induced labor in the group C. Ripeness of cervix and duration of labor were observed in each group. Results: The time from the first medication to labor and the whole birth process was significantly shorter in the group A than the group B and C (P<0.01); the dose of Misoprostol was obviously less in the group A than the group B (P<0.01). The differences were not significant in the comparison of postpartum hemorrhage and the condition of newborn among the three groups(P>0.05). Conclusion: Putting small dose of Misoprostol into posterior fornix combined with artificial rupture of membranes is one of safe and effective methods in the induced labor of term pregnancy, which can make cervical ripening, provoke contractions and promote dilation of cervix and therefore it can end delivery in a short time ......
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