目的：探究不同引产方式对剖宫产术后瘢痕子宫中晚期妊娠的影响。方法选取2012年5月至2015年4月该院收治的剖宫产术后行引产处理的瘢痕子宫中晚期妊娠患者68例，按照就诊顺序编号分为实验组和对照组。实验组患者采用腹羊膜腔行依沙吖啶注入，并接受米非司酮口服治疗；对照组使用单纯性依沙吖啶羊膜腔注入治疗，比较2组患者的临床疗效。结果（1）引产时间及宫颈成熟评分：实验组患者胎盘排出至宫缩时间[（5．62±1．34）h]和宫缩至用药时间[（29．24±4．13）h]比对照组缩短[（11．22±3．62）、（35．26±5．64）h]，差异有统计学意义（P＜0．05）；宫颈成熟评分[（8．24±2．95）分]比对照组[（6．14±1．92）分]明显上升，差异有统计学意义（P＜0．05）。（2）引产效果：实验组引产成功率（94．12％）比对照组（64．71％）高，差异有统计学意义（ P ＜0．05）。（3）分娩期并发症及药物不良反应：实验组产后出血（2．94％）、软产道损伤（20．58％）、胎盘胎膜残留发生率（0）与对照组（2．94％、17．64％、2．94％）比较，差异无统计学意义（P＞0．05），但腹泻（11．76％）、恶心呕吐（14．70％）、寒战发热发生率（14．70％）均比对照组（0、0、0）高，差异有统计学意义（P ＜0．05）。结论应用依沙吖啶＋米非司酮联合引产方案可达终止瘢痕子宫中晚期妊娠目的，引产效果确切，具有临床价值。%Objective To explore the effects of different induced labour methods on median and advanced scar uterine pregnancy after cesarean section .Methods 68 patients were selected as the research object from May 2012 to April 2015 that with median and advanced scar uterine pregnancy after cesarean section admitted and were divided in‐to the experimental group and the control group due to the sequence number of treatment .The experimental group was treated with ethacridine injection through abdominal amniotic cavity and orally taken mifepristone while the con‐trol group only with ethacridine injection through abdominal amniotic cavity and the curative effects of the two groups were compared .Results (1) The scores of duration of induced labor and cervical ripening :the time from the placenta discharge to uterine contraction of the experiment group (h :5 .62 ± 1 .34 vs .11 .22 ± 3 .62) and time from uterine contraction to medication time (h :29 .24 ± 4 .13 vs .35 .26 ± 5 .64) was lower than that of the control group (P <0 .05) .The score of cervical ripening (8 .24 ± 2 .95 vs .6 .14 ± 1 .92) significantly increased which compared with that of the control group ( P < 0 .05 ) .(2 ) The effect of induced labor : the success rate of the experimental group (94 .12% vs .64 .71% ) was higher than that of the control group (P< 0 .05) .(3)The perinatal complications and ad‐verse drug reactions :postpartum hemorrhage in the experimental group (2 .94% vs .2 .94% ) ,the soft birth canal injury (20 .58% vs .17 .64% ) and the incidence rate of retained placenta and afterbirth (0 vs .2 .94% ) did not change significantly which compared with those of the control group (P> 0 .05) ,but the occurrence rates of diarrhea (11 .76% vs .0) ,nausea and vomiting (14 .70% vs .0) and chills and fever (14 .70% vs .0) were all higher than those of the control group (P < 0 .05) .Conclusion The scheme of induced labor to use ethacridine that combined with mifepristone can reach the purpose of ending median and advanced scar uterine pregnancy and the effect of in‐duced labor was exact ,and was worthy of actively clinical reference .
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