米非司酮配伍米索前列醇不同给药方式终止早早孕的临床研究  

A clinical study of mifepristone combined with different administration of misoprostol for medical abortion in the earliest day of pregnency

作　　者：李琳[1] 王淑珍[1] 经小平[1] 翟妍[1] 

机构地区：[1]首都医科大学附属北京朝阳医院妇产科,100020

出　　处：《北京医学》2009年第6期344-346,共3页Beijing Medical Journal

摘　　要：目的对比观察米非司酮配伍米索前列醇阴道给药及舌下含服对早早期妊娠的药物流产效果。方法将70例停经妇女(停经≤37d)随机分为两组,第1天均顿服米非司酮150mg,第3天(服米非司酮36～48h后)使用米索前列醇,分为阴道给药400μg(组Ⅰ)和舌下含服400μg(组Ⅱ)两种方式以终止妊娠。结果总完全流产率为92.86%,其中组Ⅰ为97.06%,组Ⅱ为88.89%,两组比较有显著性差异(P<0.05);两组均无不全流产发生;总失败率为7.14%,其中组Ⅰ为2.94%,组Ⅱ为11.11%,两组比较有显著性差异(P<0.05);70例患者血hCG值与药物流产后的出血时间成显著正相关(P=0.000)。结论对于停经37d以内的早早孕终止妊娠,米非司酮配伍米索前列醇阴道给药能达到更好的药物流产效果,不完全流产率极低,但要警惕异位妊娠的可能。Objective To evaluate the effect of mifepristone combined with different administration of misoprostol for medical abortion in the earliest day of pregnency. Methods A total of 70 healthy women for medical abortion with gestation of up to 37 days were recruited into this study,which were randomly divided into two groups, group I and group II. To terminate pregnancy,they took 150 mg mifepristone orally on the first day, followed with 400μg misoprostol in 36 48 hours by vagina in group Ⅰ and sublingual administration in group Ⅱ. Results The complete abortion rate was 92.86% in total,while is was 97.06% and 88.89% respectively in vaginal group and sublingual group. There was significant difference of the complete abortion rate between two groups （ P 〈 0.05 ）. Incomplete abortion was not faund in two groups. The total failure rate was 7.14% , while it was 2.94% （1 /34） in vaginal group and 11.11% （4/36）in oral sublingual group ; there was significant difference of failure rate between two groups （ P 〈 0.05 ）. The level of blood β- hCG was correlated with the time of vaginal bleeding（ P = 0.000）. Conclusions Mifepristone combined with vaginal misoprostol results in higher complete abortion rate and lower failure rate as compared with mifepristone plus sublingual misoprostol, but it should be careful about the ectopic pregnancy.

关 键 词：药物流产 米非司酮 米索前列醇 

分 类 号：R169.42[医药卫生—公共卫生与预防医学] R979.1