负压吸宫术前宫颈准备的随机双盲临床研究  

Cervical Priming Prior to Vacuum Aspiration,a Randomized and Double Blind Clinical Trial

作　　者：刘晓瑷[1] 刘延[2] 王海云[3] 刘建华[4] 乔勤勤[5] 高燕[6] 

机构地区：[1]上海交通大学医学院附属国际和平妇幼保健院,200030 [2]上海交通大学医学院附属瑞金医院 [3]同济大学附属第一妇婴保健院 [4]上海交通大学医学院附属第九人民医院 [5]上海交通大学医学院附属第一人民医院 [6]复旦大学附属华东医院

出　　处：《国际生殖健康／计划生育杂志》2012年第2期89-92,共4页Journal of International Reproductive Health/Family Planning

基　　金：上海市人口计生委科技发展基金(05JG05006;2005JG04)

摘　　要：目的:探讨妊娠早期负压吸宫术前使用米非司酮和米索前列醇促宫颈成熟的适宜时间与剂量。方法:随机双盲安慰剂模拟对照多中心临床研究,纳入900例妊娠10周以内的初次妊娠(或仅有1次早期流产史)妇女,观察比较米非司酮100 mg在术前12 h服用(A组)或术前36 h服用(B组)、米索前列醇在术前3 h服用0.6 mg(C组)或0.4 mg(D组)对宫颈软化的作用。结果:米非司酮的效果显示,宫颈扩张有效率A组为65.73%,B组为77.10%(P=0.01);宫颈扩张平均值A组为(6.21±1.08)mm,B组为(6.66±1.17)mm,2组差异有统计学意义(P<0.01);无论是否初次妊娠、是否静脉麻醉,均显示与总体情况一致的趋势。米索前列醇的效果显示,宫颈扩张有效率C组为75.1%,D组为70.3%(P=0.261);宫颈扩张平均值C组为(6.64±1.15)mm,D组为(6.41±1.15)mm,2组差异有统计学意义(P=0.04);初次妊娠对象显示与总体情况一致的趋势。结论:米非司酮100 mg术前36 h口服,或米索前列醇0.6 mg术前3 h口服是较合适的妊娠早期负压吸宫术前促宫颈软化的方法,米索前列醇更具有临床实用性。Objective： To evaluate the suitable time and dosage of mifepristone and misoprostol for the cervical priming prior to vacuum aspiratiorr Methods： This is a randomized and double blind clinical trial. 900 cases of pregnant woman who was primi-gravid or had only once early abortion were randomly divided into four groups. 100 mg of mifepristone were given at 12 h （group A） or 36 h （group B） pre-operation. 0.6 mg （group C） or 0.4 mg （group D） of misoprostol were given at 3h pre-operation. Effects of mifepristone and misoprostol on cervical priming were compared. Results： The effective rates of cervical dilatation of mifepristone in group A and group B were 65.73% and 77.10% （P=O.O1）, while the mean values of cervical dilatation were （6.21±1.08） mm and （6.66±1.17） ram, respectively （P〈O.01）. The difference was insignificant when compared those results between people being primi- gravida or not, or compared people under anesthesia or not. The effective rates of cervical dilatation of misoprostol in group C and group D were 75.1% and 70.3% （P=-0.261 ）, while the mean values of ervical dilatation were （6.64±1.15 ） mm and （6.41±1.15） ram, respectively （P=0.04）. Effectofmisoprostolinprimi-gravidawomenwasidentifiedwith that of overall people. Conclusions： 100 mg of mifepristone at 36 h pre-operation or 0.6 mg of misoprostol at 3 h pre--operation was suitable for the cervical priming prior to vacuum aspiration, and misoprostol was more practical.

关 键 词：妊娠初期 流产 人工 米索前列醇 米非司酮 子宫颈 病例对照研究 

分 类 号：R169.42[医药卫生—公共卫生与预防医学]