氯化钾胎心内注射联合利凡诺羊膜腔内注射终止中期妊娠的临床研究
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摘要
目的探讨氯化钾胎心内注射联合利凡诺羊膜腔内注射终止中期妊娠的临床效果。方法选取北京大学第三医院2014年8月至2015年9月要求终止中期妊娠的孕妇60例,根据采用方法不同分为观察组(20例)和对照组(40例),观察组采用氯化钾胎心内注射联合利凡诺羊膜腔内注射终止妊娠,对照组采用利凡诺羊膜腔内注射终止妊娠。比较两组宫缩发动时间、总产程、产后出血量、产后清宫情况、产后住院时间及产后月经恢复时间。结果观察组总产程、产后出血量、产后住院时间均少于对照组,但差异无统计学意义(P>0.05)。产后清宫率观察组(35.0%)低于对照组(67.5%),差异有统计学意义(P<0.05)。结论采用氯化钾胎心内注射联合利凡诺羊膜腔内注射终止中期妊娠可降低产后因胎盘胎膜残留行清宫术率,保护子宫内膜,同时产程较短、出血量少、术后恢复快,值得临床推广应用。
Objective To investigate the clinical effect of potassium chloride intracardiac injection combined with rivanol intra-amniotic cavity injection in terminating mid-term pregnancy. Methods 60 pregnant women who asked for terminating the mid-term pregnancy from August 2014 to September 2015 in Third Hospital of Peking University were divided into observation group( n =20) and control group( n = 40) by different methods. The observation group was treated with potassium chloride intracardiac injection combined with rivanol intra-amniotic cavity injection to terminate the pregnancy,and the control group was treated only with rivanol amniotic cavity injection. Labor time,total length of labor,postpartum hemorrhage,curettagerate,postpartum hospitalization and postpartum menstrual recovery time of the two groups were compared. Results The total length of labor time,postpartum hemorrhage and postpartum hospitalization time of the observation group were less than the control group,but the difference were not statistically significant( P > 0. 05). Curettage rate of the observation group( 35 %) was lower than the control group( 67. 5 %),the difference was statistically significant( P < 0. 05). Conclusion The combination of intracardiac injection of potassium chloride and intra-amniotic cavity injection of rivanol can significantly reduce the curettage rate,protect endometrium,and have shorter labor time and less bleeding,is worthy of clinical application.
Objective To investigate the clinical effect of potassium chloride intracardiac injection combined with rivanol intra-amniotic cavity injection in terminating mid-term pregnancy. Methods 60 pregnant women who asked for terminating the mid-term pregnancy from August 2014 to September 2015 in Third Hospital of Peking University were divided into observation group( n =20) and control group( n = 40) by different methods. The observation group was treated with potassium chloride intracardiac injection combined with rivanol intra-amniotic cavity injection to terminate the pregnancy,and the control group was treated only with rivanol amniotic cavity injection. Labor time,total length of labor,postpartum hemorrhage,curettagerate,postpartum hospitalization and postpartum menstrual recovery time of the two groups were compared. Results The total length of labor time,postpartum hemorrhage and postpartum hospitalization time of the observation group were less than the control group,but the difference were not statistically significant( P > 0. 05). Curettage rate of the observation group( 35 %) was lower than the control group( 67. 5 %),the difference was statistically significant( P < 0. 05). Conclusion The combination of intracardiac injection of potassium chloride and intra-amniotic cavity injection of rivanol can significantly reduce the curettage rate,protect endometrium,and have shorter labor time and less bleeding,is worthy of clinical application.
引文
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[4]鲁霞.脐静脉穿刺注射氯化钾配合米非司酮与依沙丫啶用于完全性前置胎盘引产1例[J].中外医学研究,2011,9(31):55.
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[6]Govender L,Moodley J.Late termination of pregnancy by intracardiac Potassium chloride injection:5 years'experience at a tertiary referral centre[J].S Afr Med J,2012,103(1):47-51.
[7]Tocce K,Leach K K,Teal S B,et al.Umbilical cord transection to induce fetal demise prior to second-trimester D&E abortion[J].Contraception,2013,88(6):712–716.
[8]陈义波,李丽,黄昊.胎儿心腔注射氯化钾在中晚期妊娠并前置胎盘引产中的价值[J].临床误诊误治,2009,22(4):21-22.
[9]Sfakianaki,KJ Davis,JA Copel,et al.Potassium chloride–induced fetal demise:A retrospective cohort study of efficacy and safety[J].J Ultrasound Med 2014,33(2):337–341.
[2]刘志萍.药理学[M].武汉:湖北科学技术出版社,2010:133.
[3]尹明华.胎儿心腔注射氯化钾在中晚期妊娠合并前置胎盘引产中的效果观察[J].中国计划生育和妇产科,2015,7(2):65-67.
[4]鲁霞.脐静脉穿刺注射氯化钾配合米非司酮与依沙丫啶用于完全性前置胎盘引产1例[J].中外医学研究,2011,9(31):55.
[5]Colleen C.Induction of fetal demise before pregnancy termination:practices of family planning providers,Contraception 92[Z],2015:241–245.
[6]Govender L,Moodley J.Late termination of pregnancy by intracardiac Potassium chloride injection:5 years'experience at a tertiary referral centre[J].S Afr Med J,2012,103(1):47-51.
[7]Tocce K,Leach K K,Teal S B,et al.Umbilical cord transection to induce fetal demise prior to second-trimester D&E abortion[J].Contraception,2013,88(6):712–716.
[8]陈义波,李丽,黄昊.胎儿心腔注射氯化钾在中晚期妊娠并前置胎盘引产中的价值[J].临床误诊误治,2009,22(4):21-22.
[9]Sfakianaki,KJ Davis,JA Copel,et al.Potassium chloride–induced fetal demise:A retrospective cohort study of efficacy and safety[J].J Ultrasound Med 2014,33(2):337–341.