目的:探讨米非司酮配伍卡前列甲酯、乳酸依沙吖啶和水囊用于瘢痕子宫中期妊娠引产的临床效果.方法:选择我院瘢痕子宫妊娠自愿要求引产孕妇90例,选用米非司酮配伍卡前列甲酯药物引产为A组,乳酸依沙吖啶羊膜腔内注射引产为B组,水囊引产为C组.观察三组患者引产情况.结果:三组孕妇引产的成功率及产后出血量无明显统计学意义(P＞0.05);米非司酮配伍卡前列甲酯药物引产和C组水囊引产时间明显短于B组乳酸依沙吖啶羊膜腔内注射引产,差异有统计学意义(P＜0.05);乳酸依沙吖啶羊膜腔内注射引产的清宫率为53.3％ (16/30),明显高于A组的10％ (3/30)和C组的16.7％ (5/30),差异均有统计学意义(P＜0.05);但C组和A组比较,差异无统计学意义(P＞0.05).三组均未发生会阴裂伤、胎盘早剥、子宫破裂和产褥感染.结论:对于瘢痕子宫孕妇妊娠中晚期引产,米非司酮配伍卡前列甲酯、乳酸依沙吖啶和水囊用于瘢痕子宫中期妊娠引产均可行,但需要根据孕妇的具体情况选择适宜的引产方案.%Objectives:To compare the clinical effect of carprost combined with mifepristone,ethacridine lactate and water bag in midtrimester pregnancy of scarred uterus.Methods:90 patients who required to terminate midtrimester pregnancy were divided into 3 groups:mifepristone with carboprost methylate (Group A,30 cases),ethacridine lactate (Group B,30 cases) and water bag induction (Group C,30 cases).Effects of induced abortion between the 3 groups were compared.Results:There was no significant difference in bleeding amount and success abortion rate among three groups (P ＞ 0.05).The induction time of Group A and Group C were shorter than that of Group B,with statistically significant difference (P ＜ 0.05).The complete abortion rate in group B was 53.3％,which was higher than these of group A and group C,with statistically significant difference (P ＜ 0.05),but there was no significant difference between group A and group C (P ＞ 0.05).There were no severe complications such as perineal laceration,placental abruption,uterine rupture and puerperal infection in the three groups.Conclusion:There are pros and cons for the application of three methods for induced labor to midtrimester pregnancy with scarred uterus.The appropriate induction programs should be chosen depending on the circunstances of pregnant women.
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