不同剂量米索前列醇终止早期妊娠失败的临床研究  

Clinical study on effect of different doses of misoprostol on early pregnancy failure cases

作　　者：李金凤[1] 盖立文[1] 

机构地区：[1]山东省滕州市中心人民医院妇产科,277500

出　　处：《中国妇幼保健》2009年第19期2696-2698,共3页Maternal and Child Health Care of China

基　　金：滕州市科技发展计划第一批〔2008029〕

摘　　要：目的:探讨单纯米索前列醇终止早期妊娠失败的临床疗效。方法:选择早期妊娠失败的患者310例,随机分为两组,Ⅰ组为研究组,采用阴道后穹窿放置米索前列醇,Ⅱ组为对照组,采用人工负压吸引术。再将Ⅰ组随机分为3个亚组,即Ⅰa、Ⅰb、Ⅰc组,分别给予米索前列醇400μg、600μg、800μg3个不同剂量,比较分析完全流产率、药物不良反应发生率、流产并发症发生率、月经复潮情况。结果:①Ⅰ组3个亚组之间,在完全流产率、流产并发症发生率方面,Ⅰa组与Ⅰb、Ⅰc组比较差异有统计学意义(P<0.01,P<0.05),Ⅰb组与Ⅰc组比较,差异无统计学意义(P>0.05);在药物不良反应发生率方面,Ⅰa组与Ⅰc组比较差异有统计学意义(P<0.05),Ⅰb组与Ⅰc组比较差异无统计学意义(P>0.05),但Ⅰb组低于Ⅰc组;②Ⅰb组与Ⅱ组间完全流产率比较差异无统计学意义(P>0.05),在流产并发症发生率方面,Ⅰb组与Ⅱ组比较差异有统计学意义(P<0.05);③两组流产后第1次月经周期均延迟,第2、3次月经周期基本恢复正常,两组间比较差异无统计学意义(P>0.05)。结论:单纯米索前列醇终止早期妊娠失败是安全有效的方法,最佳剂量为600μg,阴道后穹窿给药不良反应小,值得临床推广,替代人工负压吸引流产术,可减少流产并发症。Objective： To explore the clinical effect of different doses of misoprostol on early pregnancy failure cases. Methods： 310 early pregnancy failure cases were divided into two groups randomly, study group （group Ⅰ ） put misoprostol in vagina, control group （group Ⅱ ） adopted artificial abortion vacuum aspiration. Then the cases in group Ⅰ were divided into Ⅰ a, Ⅰ b and Ⅰ c with the doses of 400 μg, 600 μg and 800 μg. The rate of complete abortion, the incidences of medicine side effect, complications and menstrual flow comeback time were compared. Results： （1）There was significant difference in the rate of complete abortion, the incidence of complications between Ⅰ a, Ⅰ b and Ⅰ a, Ⅰc （ P 〈 0. 01, P 〈 0. 05 ）, but there was no difference betweenⅠ b and Ⅰ c （ P 〉 0. 05 ） ; there was significant difference in incidence of medicine side effect between Ⅰ a and Ⅰ c （ P 〈 0. 05 ） , but there was no difference between Ⅰ b and Ⅰ c （ P〉 0. 05 ） ; （2）there was no difference in the rate of complete abortion between Ⅰ b and group Ⅱ , but there was significant difference in the incidence of complications between Ⅰ b and group Ⅱ （ P 〈 0. 05 ） ; （3）The first menstrual cycle of the two groups after abortion was delayed, but the second and third menstrual cycle were basically normal, there was no difference between two groups （P 〉 0. 05 ） . Conclusion： It is an effective method to stop early pregnancy failure with misoprostol. The optimal dose is about 600 μg, and the incidence of medicine side effect by putting the medicine in vagina is low, which may replace artificial abortion for reducing complications.

关 键 词：米索前列醇 早期妊娠 妊娠失败 

分 类 号：R714.1[医药卫生—妇产科学]