| 摘要: |
| 目的探讨阿托西班在晚期流产、先兆早产、前置胎盘伴出血和宫颈功能不全治疗中的效果，并分享一些用药经验。方法选择住院治疗期间曾接受阿托西班治疗的孕妇55例作为研究对象，根据入院时的孕周及主要并发症，分为晚期流产或先兆早产组（43例）、前置胎盘伴出血组（8例）和宫颈功能不全组（4例）。收集相关基本资料，以延长孕期48h和7d的有效率、孕期延长天数、母儿药物不良反应、妊娠结局和围生儿结局作为观察指标。在晚期流产或先兆早产组中，采用Kaplan-Meier生存曲线分别对不同妊娠年龄段、初产妇或经产妇、单胎妊娠或双胎妊娠、接受阿托西班治疗时孕周＜28周或≥28周孕妇的妊娠结局进行分析。结果3组孕妇孕期延长天数、妊娠终止时孕周和足月率比较差异均有统计学意义（均P＜0.05）。宫颈功能不全组孕期延长天数、妊娠终止时孕周和足月率明显大于其余两组，差异均有统计学意义（均P＜0.05）。晚期流产或先兆早产组、宫颈功能不全组妊娠终止时孕周数较阿托西班疗程开始时明显增加（均P＜0.05），而前置胎盘伴出血组妊娠终止时孕周数与阿托西班疗程开始时比较差异无统计学意义（P＞0.05）。晚期流产或先兆早产组孕妇不同妊娠年龄段、初产妇或经产妇、单胎妊娠或双胎妊娠、接受阿托西班治疗时孕周这4项指标间妊娠结局比较差异均无统计学意义（均P＞0.05）。结论阿托西班对延长宫颈功能不全孕妇的妊娠时间有显著效果，其与利托君的联合治疗方法适用于不同年龄段、产次、孕期、胎数的晚期流产或先兆早产孕妇。 |
| 关键词: 晚期流产 先兆早产 阿托西班 |
| DOI：10.12056/j.issn.1006-2785.2018.40.7.2017-1404 |
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| Atosiban in the treatment of threatened late abortion and preterm labor |
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the First Affiliated Hospital of Wenzhou Medical University
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| Abstract: |
| Objective To evaluate the efficacy of oxytocin antagonist atosiban in preventing late abortion, preterm labour, placenta previa and cervical incompetence. Methods Fifty five pregnant women receiving the treatment with atosiban in our hospital were recruited in this study. Among 55 cases, there were 43 cases of threatened late abortion or preterm labor, 8 cases of placenta previa, and 4 cases of cervical incompetence. Clinical data were collected, including the effectiveness of prolonging delivery over 48h or 7d; prolonged gestational days; drug adverse reaction; pregnancy outcome, term delivery or delivery up to expectations and perinatal outcome. In the group of threatened late abortion or preterm labor, Kaplan-Meier was used to analyze the correlation of pregnant outcomes with different variables: age ＜30 or ≥30 years, multipara or primipara, singleton pregnancy or multiple pregnancy, ＜28 or ≥28 weeks at the time of receiving atosiban. Results There were significant differences in prolonged gestational days, gestational age and term delivery rate among three groups (all P＜0.05); there indicators in cervical incompetence group were significantly higher than those in other two groups (all P＜0.05). The gestational age at delivery was longer than that at the time of receiving atosiban in late abortion or preterm labor group and cervical incompetence group (both P＜0.05), but there was no difference in placenta previa group(P ＞0.05). In the group of threatened late abortion or preterm labor, there were no significant differences in pregnancy outcome among those ＜30 or ≥30 years old, multipara or primipara, singleton
pregnancy or multiple pregnancy and ＜28 or ≥28 weeks at the time of receiving atosiban (all P ＞0.05). Conclusion The use of atosiban can effectively prolong the gestational time of patient with cervical incompetence. The sequential treatment of atosiban and ritodrine is available for patients with different ages, number of pregnancies, gestational age or fetal numbers. |
| Key words: Threatened late abortion Threatened preterm labor Atosiban |
