米非司酮配伍米索前列醇治疗稽留流产的临床观察  

Clinical observation of mifepristone combining misoprostol on missed abortion

作　　者：孙淑云[1] 王莉 王秋焕[1] 

机构地区：[1]渭南职业技术学院,陕西渭南714000 [2]渭南市中心医院,陕西渭南714000

出　　处：《中国妇幼健康研究》2011年第6期775-777,共3页Chinese Journal of Woman and Child Health Research

摘　　要：目的 探讨米非司酮配伍米索前列醇临床上治疗稽留流产的疗效.方法 选择渭南市中心医院2008年9月至2010年9月稽留流产患者74例,实验组40人,口服米非司酮（晨起50mg,睡前25mg,连服2日,总量150mg）,第3天晨起阴道后穹窿放置米索前列醇600μg,待妊娠组织物自然排出后或阴道出血量〉100mL时,行刮宫术;对照组34人,口服乙烯雌酚5mg/次,3次/日,连服5日,第6天行刮宫术,术中静滴缩宫素,分析两组服药过程中药物不良反应、妊娠物自然排出率、清宫过程中宫颈情况、手术操作难易程度、阴道出血量、再次清宫率、患者自我感觉痛苦程度及术后病理结果.结果 实验组服药过程中不良反应较轻;妊娠物自然排出率高于对照组（χ2=48.59,P〈0.01）;清宫过程中,实验组宫颈条件好,不需扩宫,手术时间短（7.30±2.58分钟vs 14.49±3.47分钟,t=3.48,P〈0.05）,术中人流综合征发生率低（χ2=4.50,P〈0.05）,术中出血量少（35.60±14.70 mL vs 86.47±20.70mL,t=4.47,P〈0.05）,再次清宫率低（χ2=14.19,P〈0.01）,且患者痛苦小.结论 米非司酮配伍米索前列醇治疗稽留流产临床疗效好,术中及术后并发症少,且患者痛苦较轻,适宜应用于临床.Objective To discuss the curative effect of mifepristone combining misoprostol on missed abortion. Methods Among 74 patients with missed abortion in Weinan Central Hospital from September 2008 to September 2010, 40 patients （ study group） were treated with mifepristone orally （50rag in the morning and 25mg before sleep, 2 days, total dosage of 150mg） and misoprostol in vagina （600μg at third morning）. When pregnancy organization content was educated naturally or the amount of vaginal hemorrhage was more than 100mL, curettage was performed. The other 34 patients （control group） were treated with diethylstilbestrol for 5 days （Smg, tid）, and then curettage was performed at sixth day. During the operation oxytocin was given by intravenous drip. Adverse drug reactions, the spontaneous discharging rate of pregnancy tissue, cervical condition, difficulty level of curettage, amount of vaginal bleeding, rate of second curettage, patients＇ feelings and pathological results of two groups were analyzed. Results Drug adverse reactions of the study group were comparatively slight, and the spontaneous discharging rate of pregnancy tissue was higher than that of control group （2,2 = 48.59, P 〈 0.01 ）. In the study group the cervical condition was good, without dilatating uterus and with short operation time （7.30 ± 2.58rains vs 14.49 ± 3.47mins, t = 3.48, P 〈 0.05 ）, low incidence of abortion syndrome （X2 = 4.50, P 〈 0.05 ）, few vaginal bleeding during curettage （35.50 ± 14.70 mL vs 86.47± 20.70mL, t = 4.47, P 〈 0.05 ）, low rate of second curettage （X2 = 14. 19, P 〈 0.01 ） and less pains. Conclusion Mifepristone combining misoprostol has good clinical therapeutic effects on missed abortion with less complications during and after curettage and less suffering. Mifepristone combining misoprostol can be applied in clinics.

关 键 词：米非司酮 米索前列醇 稽留流产 清宫 

分 类 号：R714.21[医药卫生—妇产科学]