目的分析地诺前列酮栓不同放置时间用于足月妊娠促宫颈成熟及引产的临床效果。方法选取足月妊娠、宫颈 Bishop 评分为3~5分、有引产指征而无禁忌证初产妇160例，随机分为常规放置时间组（常规放药12~24 h）和缩短放置时间组（放置12 h 取药）。两组放药后24 h 未临产者行缩宫素引产。比较两组孕妇用药后宫颈变化、缩宫素使用、临产时间、产程时间、分娩及新生儿情况。结果常规放置时间组放药12~24 h 阴道分娩率（38.75%）及临产率（22.50%）均高于缩短放置时间组（28.75%，18.75%），宫颈成熟率低于缩短放置时间组（5.00% vs.11.25%），但差异无统计学意义（ P ＞0.05）；24~48 h 缩短放置时间组阴道分娩率（43.75%）、临产率（10.00%）及宫颈成熟率（2.50%）高于常规放置时间组（17.50%，0，0），差异有统计学意义（ P ＜0.05）。缩短放置时间组缩宫素使用率（38.75%）高于常规放置时间组（23.75%），临产所用时间（24.5±14.6 h）长于常规放置时间组（14.6±7.2 h），差异均有统计学意义（ P＜0.05）；两组产程时间比较7.5±3.6 h vs.7.8±4.0 h，差异无统计学意义（ P =0.67）；常规放置时间组剖宫产率（42.50%）高于缩短放置时间组（12.50%），差异有统计学意义（ P ＜0.05）；两组引产失败率相同；两组羊水污染率、产后2 h 出血量、新生儿1 min Apgar 评分及出生体重比较差异均无统计学意义（ P ＜0.05）。结论地诺前列酮栓用药12 h 促足月妊娠宫颈成熟及引产，引产成功率与常规用药相同，但剖宫产率低、缩宫素使用率高、引产时间延长。%Objective To analyze the efficacy of dinoprostone in different periods for artificial labors. Methods 160 pregnant women at 37 to 41 weeks of gestation without any severe complication,with cervical Bishop scores of 3 ~ 5 points,were randomly divided into two groups:routine medication group(using 12 ~ 24 hours for placement of dinoprostone)and shortened medication group(using 12 hour for placement of di-noprostone). If they were not in labor after 24 hours,then oxytocin induction was done. The maternal cervical Bishop scores,oxytocin induction of labor,mode of delivery,the time for labor,total stage of labor and neonatal situation were compared between these two groups. Results The vaginal delivery rate(38. 75% )and birth rate(22. 50% )in routine medication group during 12 to 24 hours were higher than those of shortened group(28. 75% ,18. 75% ),its cervical maturation rate(5. 00% )was less than that of shortened group(11. 25% ),but the difference was not statistically significant( P > 0. 05). The vaginal delivery rate(43. 75% ),birth rate(10. 00% )and cervical maturation rate(2. 50% )in short-ened group during 24 to 48 hours were higher than those of routine group(17. 50% ,0 and 0),and the difference was statistically significant( P< 0. 05). The rate of application of oxytocin(38. 75% )in shortened group was higher than that of routine group(23. 75% ),and its labor time was longer(24. 5 ± 14. 6 h)than that of routine group(14. 6 ± 7. 2 h),and the difference was statistically significant( P < 0. 05). The differ-ence in total stage of labor between these two groups(7. 5 ± 3. 6 h vs. 7. 8 ± 4. 0 h)was not statistically significant( P > 0. 05). The rate of ce-sarean section in routine group was higher than that of shortened group(42. 50% vs. 12. 50% ),and the difference was statistically significant( P < 0. 05),and the difference in rate of failed induction between these 2 groups was not significant. There was no significant difference in the rate of amniotic fluid contamination and postpartum hemorrhage. The difference in Apgar scores and birth weight between these two groups was signifi-cant( P > 0. 05). Conclusion The successful rate of induced labor is same as routine medication in term of pregnancy by using dinoprostone for 12 hours,but the rate of cesarean section is lowered,and the rate of application of oxytocin is higher,but the induction time is extended.
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