稽留流产不同治疗方式的临床观察  

Therapeutic effects of diffetent medication modes on missed abortion

作　　者：张艺玮[1] 陈晶[2] 潘晓伟 ZHANG Yiwei;CHEN Jing;PAN Xiaowei(Department of Gynecology,The First Hospital of Shijiazhuang City,Hebei,Shijiazhuang 050011,China)

机构地区：[1]河北省石家庄市第一医院妇科,050011 [2]河北省石家庄市第一医院麻醉科,050011

出　　处：《河北医药》2018年第5期742-744,共3页Hebei Medical Journal

基　　金：石家庄市科学技术研究与发展计划项目(编号:151461313)

摘　　要：目的比较四种不同用药方法治疗稽留流产的临床效果。方法收治的200例稽留流产患者依据戊酸雌二醇不同剂量配伍米非司酮和米索前列醇不同剂量及不同应用方法分为试验A组、B组、C组,米非司酮配伍米索前列醇为对照组。观察4组间完全流产率、流产后阴道出血量、流产后阴道出血时间、流产失败率、再次清宫率及再次妊娠情况。结果试验组(A组、B组、C组)的完全流产率高于对照组;试验组(A组、B组、C组)流产失败率、再次清宫率明显低于对照组;试验组(A组、B组、C组)平均阴道出血量、流产后阴道出血时间、月经复潮时间明显短于对照组,差异均有统计学意义(P<0.05)。试验组(A组、B组、C组)之间相比,差异无统计学意义(P>0.05)。试验组(A组、B组、C组)再次妊娠率与对照组之间差异无统计学意义(P>0.05)。试验组(A组、B组、C组)再次妊娠率之间比较,差异无统计学意义(P>0.05)。结论戊酸雌二醇配伍米非司酮和米索前列醇治疗稽留流产比使用米非司酮及米索前列醇临床疗效好,戊酸雌二醇不同剂量配伍米非司酮和米索前列醇不同剂量及不同应用方法在临床效果中无明显不同,在四种治疗方式中没有一种方式对再次妊娠有独特的优势。Objective To observe and compare the therapeutic effects of diffetent medication ways on missed abortion.Methods A total of 200 patients with missed abortion were enrolled in the study.According to the different doses of estradiol valerate combined with different doses of mifepristone and misoprostol by means of medication ways,these patients were divided into four groups:experimental group A,B,C groups and control group(mifepristone with misoprostol).The complete abortion rate,vaginal bleeding volume after abortion,vaginal bleeding time after abortion,abortion failure rate,the second time curettage rate and the second time pregnancy rate were observed and compared among the four groups.Results The complete abortion rate in three experimental groups were obviously higher than that in control group,however,the abortion failure rate and the second time curettage rate in three experimental groups were significantly higher than those in control group,moreover,the average vaginal bleeding volume,postpartum vaginal bleeding time,menstrual resurgence time in three experimental groups were significantly shorter than those in control group(P<0.05).However there were no significant differences in these indexes mentioned above among three experimental groups(P>0.05).In addition there was no significant difference in the second pregnancy rate between the three experimental groups and control group(P>0.05).Moreover there was no significant difference in the second time pregnancy rate among the three experimental groups(P>0.05).Conclusion The therapeutic effects of combination application of estradiol valerate with mifepristone and misoprostol on missed abortion are superior to those by simple mifepristone or simple misoprostol,however,there are no significant differences in different doses of estradiol valerate combined with mifepristone and misoprostol by means of different medication ways,and none of the four treatment modes has unique advantages on the second pregnancy.

关 键 词：稽留流产 胚胎停育 戊酸雌二醇 米非司酮 米索前列醇 再次妊 

分 类 号：R714.21[医药卫生—妇产科学]