观察间苯三酚与利多卡因联合阿托品在宫颈水肿治疗中的疗效。

选择2008年1月至2013年1月于成都市妇女儿童中心医院妇产科住院治疗的产程中发生宫颈水肿的526例初产妇为研究对象，采用随机抽样法将其分为实验A组(n＝176，使用利多卡因联合阿托品)、实验B组(n＝187，使用间苯三酚)和对照组(n＝163，无特殊药物治疗)3组。本研究遵循的程序符合成都市妇女儿童中心医院人体试验委员会制定的伦理学标准，得到该委员会批准，分组征得受试对象本人的知情同意，并与之签署临床研究知情同意书。3组产妇年龄、孕龄、体质量、身高、发生宫颈水肿时宫颈口扩张程度、新生儿出生体质量比较，差异均无统计学意义(P>0.05)。比较3组患者治疗效果、母婴分娩结局及药物不良反应。

实验A组、实验B组治疗后2 h宫颈水肿消退率、宫颈口扩张程度、经阴道分娩率均高于对照组[90.9%和94.7% vs 68.1%，(3.5±0.3)cm和(4.6±0.4)cm vs (2.4±0.5)cm, 91.5%和95.7% vs 82.8%]，阴道分娩者宫颈口开全时间均短于对照组[(4.5±0.5)h和(3.7±0.4)h vs (5.9±0.6)h]，前二者分别和对照组比较，差异均有统计学意义(χ²＝27.460和42.129，t＝5.234和3.370，χ²＝5.724和15.705，t＝2.169和18.170；P<0.05)。而实验A组和实验B组上述各观察指标比较，差异均无统计学意义(P>0.05)。3组产妇产后2 h出血量与新生儿窒息率比较，差异无统计学意义(P>0.05)。实验A组治疗后出现口干、心率增快伴胎儿胎心率基线升高产妇为68例(38.6%)，实验B组无一例产妇出现药物不良反应。

间苯三酚静脉推注及利多卡因联合阿托品宫颈注射对治疗宫颈水肿均有显著效果，但前者疗效更为显著。间苯三酚具有使用安全、无明显药物不良反应的优点。

To observe the clinical effects of phloroglucinol and atropine combined with lidocaine in cervical dropsy.

From January 2008 to January 2013, a total of 526 primipara in labor with cervical dropsy were randomly included in the study.They were divided into group A (n=176, treated with atropine combined with lidocaine), group B (n=187, treated with phloroglucinol) and control group(n=163, regular treatment). The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Chengdu Women's and Children's Central Hospital.Informed consent was obtained from each participants.There were no significant differences at age, gestational age, weight, height, cervix dilatation before treatment, birth weight of newborns among three groups(P>0.05). The clinical effects, perinatal outcomes and adverse drug reactions were compared among three groups.

The relieve rates of cervical dropsy at 2 hours after treatment, cervix dilatation at 2 hours after treatment and transvaginal delivery rates of group A and group B were higher than those of control group, respectively[90.9% and 94.7% vs 68.1%, (3.5±0.3)cm and (4.6±0.4)cm vs (2.4±0.5)cm, 91.5% and 95.7% vs 82.8%], meanwhile the duration of uterus opening to the full extent of group A and group B were respectively shorter than those of control group[(4.5±0.5)h and (3.7±0.4)h vs (5.9±0.6)h], all the differences above were significant(χ²=27.460 and 42.129, t=5.234 and 3.370, χ²=5.724 and 15.705, t=2.169 and 18.170; P<0.05). There were no significant differences in relieve rates of cervical dropsy at 2 hours after treatment, cervix dilatation at 2 hours after treatment, transvaginal delivery rates and duration of uterus opening to the full extent between group A and group B(P>0.05). No significant differences were found in postpartum hemorrhage volume at 2 hours after treatment and incidence of neonate asphyxia among three groups(P>0.05). There were 68 women had symptoms of thirsty, increased heart rate accompanied with elevated fetal heart rate baseline in group A. No one had adverse drug reactions in group B.

Although both phloroglucinol and atropine combined with lidocaine can effectively improve cervical dropsy, phloroglucinol was better.Phloroglucinol had advantages in safe and no adverse drug reactions.