中期妊娠两种联合用药引产效果及安全性比较  

Clinical observation of two therapies for induced abortion

作　　者：张一萍[1] 

机构地区：[1]武警北京总队第三医院妇科,100141

出　　处：《武警医学》2012年第9期784-786,共3页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的观察米非司酮分别与米索前列醇、依沙吖啶联合用于终止14～27周妊娠的临床效果及安全性。方法选择妊娠14～27周,自愿要求终止妊娠的健康女性120例,随机分为A、B两组,A组60例予米非司酮、米索前列醇序贯口服;B组60例予米非司酮口服、依沙吖啶羊膜腔注射。观察两种引产方法的成功率、手术清宫率、用药至分娩时间、出血量、药物不良反应及并发症。结果米非司酮分别与米索前列醇、依沙吖啶联合用于终止14～27周妊娠均取得较好效果,在流产成功率、出血量、安全性方面差异无统计学意义。前者无需羊膜腔给药,手术清宫率低于后者(P<0.05),减少了医源性感染的机会,但较大孕周时米索前列醇的给药间隔及用量需在严密监测下根据个体差异适时调整,因此更适合应用于终止16周以下妊娠;后者用药方法相对简单、安全,值得在16周以上中期引产推广使用。结论米非司酮分别与米索前列醇、依沙吖啶联合用于中期妊娠流产的方法,效果确切,不良反应及并发症少,值得临床推广。Objective To observe the efficacy and safety of using mifepristone combined with misoprostol and ethacridine re spectively in induced termination of pregnancy during the second and third trimester. Methods 120 women undergoing legal induced abortion during the second and third trimester were divided randomly into two groups. Group A with 60 patients were given oral mife pristnne and misoprostol sequentially while 60 patients in group B were given mifepristone orally and ethacridine by amniotie injection. The rate of success and surgical evacuation, induction abortion interval, blood loss, side effects and complications were observed. Results Both methods achieved good results, without significant difference in terms of bleeding or safety. The former, without anmiot ic administration, had a lower surgical evacuation rate than the latter （ P 〈 0.05 ） so that the chance of iatrogenie infection was re duced. However, when used in a larger gestational age, the dose of misoprostol should be adjusted carefully according to individual differences under close monitoring. Misoprostol seems more suitable for terminating pregnancy less than 16 weeks. The second method, with simple management, is worthy of popularization for induced abortion above 16 weeks. Conclusion Mifepristone combined with misoprostol and ethacridine respectively for mid and third trimester abortion is a highly effective method with fewer side effects and com plications.

关 键 词：妊娠中期 引产 米非司酮 米索前列醇 依沙吖啶 

分 类 号：R169.42[医药卫生—公共卫生与预防医学]