大剂量米非司酮治疗早期人工流产术后不全流产的临床疗效  

Clinical efficacy of high-dose mifepristone in the treatment of incomplete abortion after early artificial abortion

作　　者：邓月月[1] 孙文超[1] 

机构地区：[1]杭州市第一人民医院钱江院区杭州市妇产科医院,浙江杭州310008

出　　处：《中国现代医生》2017年第5期48-51,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2014KYA267)

摘　　要：目的探讨大剂量米非司酮对早期人工流产术后流产不全的临床疗效。方法选取2015年6月~2016年6月在我院实施早期人工流产术,术后经子宫超声检查(B超)证实流产不全的患者100例,随机分为研究组和对照组、每组各50例,研究组患者给予大剂量米非司酮,对照组患者给予复方生化汤加减治疗,两组用药疗程均为1周。比较两组患者治疔前、后各项临床疗效指标。结果服药3~4 d,研究组中途因质疑用法用量退出3例,1例中途转为宫腔镜治疗,对照组1例转再次清宫手术、1例转宫腔镜手术,1例转米非司酮药物治疗,两组比较,差异无统计学意义(P>0.05);研究组治疗后血HCG下降值、宫内残留物缩小值,临床总有效率均明显高于对照组,差异有统计学意义(P<0.05);研究组患者的平均月经复潮时间明显低于对照组(P<0.05),而两组阴道流血时间差异不显(P>0.05);研究组患者治疗后并发症发生率明显低于对照组,差异有统计学意义(P<0.05)。结论应用大剂量米非司酮治疗早期人工流产术后不全流产有较好的临床效果,但在治疗期间应密切关注患者有无不良反应、以免大剂量药物引发中毒。Objective To investigate the clinical efficacy of high-dose mifepristone on the incomplete abortion after early abortion. Methods A total of 100 patients who were given early abortion in our hospital and were diagnosed with incomplete abortion by uterine ultrasonography（B ultrasound） from June 2015 to June 2016 were selected. They were randomly divided into the study group and the control group, with 50 patients in each group. The study group was given high dose of mifepristone, and the control group was given modified therapy of compound shenghua decoction. Both g/~oups were treated for 1 week. The indices of clinical efficacy were compared before and after the treatment in both groups. Results The patients were administered for 3-4 days, and 3 cases were withdrawn in the study group due to suspicion of usage and dosage, and 1 case was transferred to hysteroscopy. In the control group, one case was trans- ferred to curettage again, one case was transferred to hysteroscopic surgery, and one case was transferred to the therapy of mifepristone. There was no significant difference between the two groups （P〉0.05）; The reduction rate of blood HCG, the reduction of intrauterine residue and the total clinical effective rate in the study group ＇after the treatment were sig- nificantly higher than those in the control group, and the differences were statistically significant（P〈O.05）; the average time of return of menses in the study group was significantly lower than that in the control group（P〈0.05）, and there was no significant difference in vaginal bleeding time between the two groups（P〉0.05）; the incidence of complications in the study group after the treatment was significantly lower than that in the control group, and the difference was statistically significant（P〈0.05）. Conclusion The application of high dose of mifepristone in the treatment of incomplete abortion after early abortion has a good clinical effect, but during the treatment, adverse reactions should be closely monito

关 键 词：大剂量米非司酮 人工流产术 不全流产 并发症 

分 类 号：R169.4[医药卫生—公共卫生与预防医学]