摘要
目的:探讨地诺前列酮阴道栓剂联合地西泮静脉推注用于低宫颈成熟度的足月初产妇无痛引产的临床效果及安全性。方法:采用信封法随机抽取100例拟阴道试产的初孕妇(Bishop评分<3分),分为观察组和对照组,观察组入组47例,对照组入组44例;观察组地诺前列酮阴道栓剂取出后缓慢静脉推注地西泮10 mg,2 h后根据宫缩情况采用缩宫素引产;对照组取药后根据宫缩情况直接采用缩宫素引产。两组均在宫口开大3 cm采用硬脊膜穿破硬膜外阻滞麻醉进行分娩镇痛,比较两组产妇第1产程和总产程的时间、阴道分娩率、产后出血及新生儿窒息率。结果:观察组第一产程和总产程时间分布明显短于对照组,差异有统计学意义(P=0.004);观察组阴道分娩率(74.5%)明显高于对照组阴道分娩率(54.5%),差异有统计学意义(P=0.047);同时,两组新生儿窒息率差异无统计学意义(P=1.000)。结论:应用地诺前列酮阴道栓剂联合地西泮有助于缩短足月初产妇的产程,且对孕妇和新生儿无不良影响。
Objective:To investigate the effects of benzodiazepines in nulliparous women with an unfavorable cervix at term undergoing induction of labor by dinoprostone for labor analgesia.Methods:A total of 100 nulliparous women who planned for vaginal delivery and had a Bishop score of<3 were divided into an observation group(n=47)and a control group(n=44)by envelop randomization.In the observation group,10 mg of benzodiazepines were injected intravenously for 2 hours after removal of dinoprostone,and then oxytocin was started to initiate uterine contractions.In the control group,oxytocin was directly used to induce uterine contractions after the removal of dinoprostone.When dilation of the cervix was 3 cm,the dural puncture epidural block was used for labor analgesia in the above two groups.The first stage of labor time,total labor time,the rate of vaginal delivery,postpartum hemorrhage of nulliparous women,and the incidence of neonatal asphyxia between the two groups were compared.Results:Compared with that respectively in the control group,the time for both the first stage and the total stage of labor was significantly shorter in the observation group(P=0.004);the vaginal delivery rate was 74.5% in the observation group,which was significantly higher than 54.5% in the control group(P=0.047).At the same time,there was no significant difference in neonatal asphyxia rate between the two groups(P=1.000).Conclusion:The use of benzodiazepines could shorten the labor time of nulliparous women at term undergoing induction of labor by dinoprostone and has no adverse effects on delivery outcomes.
作者
乔媛
黄凤华
李家福
吴雪春
陈慧君
QIAO Yuan;HUANG Fenghua;LI Jiafu;WU Xuechun;CHEN Huijun(Dept.of Obstetrics,Zhongnan Hospital of Wuhan University,Wuhan 430071,Hubei,China)
出处
《武汉大学学报（医学版）》
CAS
2024年第5期589-593,共5页
Medical Journal of Wuhan University
关键词
地诺前列酮阴道栓剂
地西泮
足月妊娠
初产妇
引产
Dinoprostone
Benzodiazepines
Fullterm Births
Nulliparity
Induction of Labor
作者简介
乔媛,女,1984-,医学博士,副主任医师,主要从事产程管理和镇痛分娩、妊娠合并症、危急重症和前置胎盘等疾病的研究,E-mail:qiaoyuan@znhospital.cn;通讯作者:陈慧君,女,1981-,医学博士,主任医师,主要从事产程管理和镇痛分娩、妊娠合并症、危急重症和前置胎盘等疾病的研究,E-mail:karrel@sina.com。
