米索前列醇400μg舌下含服与800μg阴道给药用于早孕药物流产的效果比较  

Comparison of the efficacy of 400μg sublingual misoprostol versus 800μg vaginal misoprostol for medical abortion in early pregnancy

作　　者：杜丽蓓 李幸奂 袁外香 杨玉琪 任婷婷 何柏松 DU Libei;Li Hang Wun Raymond;YUAN Waixiang;YANG Yuqi;REN Tingting;Ho Pak Chung(Department of Obstetrics and Gynaecology,the University of Hong Kong-Shenzhen Hospital,Guangdong Province,Shenzhen 518000,China;不详)

机构地区：[1]香港大学深圳医院妇产科,广东省深圳市518000 [2]香港大学玛丽医院妇产科,中国香港

出　　处：《临床合理用药杂志》2022年第11期23-27,共5页Chinese Journal of Clinical Rational Drug Use

基　　金：深圳市卫生计生委员会非资助项目(SZFZ2017014)。

摘　　要：目的比较米索前列醇400μg舌下含服与800μg阴道给药用于早孕药物流产的效果。方法选择2017年10月1日—2019年10月30日在香港大学深圳医院妇科进行药物流产的患者105例,采用随机分组原则分为舌下含服组53例和阴道给药组52例,分别于接受米非司酮片200 mg 48 h后,给予米索前列醇400μg舌下含服或给予米索前列醇800μg阴道给药,比较2组患者应用米索前列醇当天孕囊排出率、完全流产率、不完全流产率、孕囊排出时间、阴道出血持续时间、阴道出血量、疼痛评分、疼痛持续时间及不良反应。结果2组患者应用米索前列醇当天孕囊排出率及完全流产率比较差异均无统计学意义(P>0.05)。舌下含服组患者应用米索前列醇后至当天孕囊排出时间短于阴道给药组(P<0.01)。2组患者阴道出血持续时间、阴道出血量、疼痛评分、疼痛持续时间及不良反应比较差异均无统计学意义(P>0.05)。结论米索前列醇400μg舌下含服与800μg阴道给药均可用于早孕药物流产,但400μg舌下含服患者的孕囊排出更快,且由于舌下含服方案用药方便,同时减少了米索前列醇的用量,降低了成本,值得进一步推广使用。Objective To compare the efficacy of 400μg sublingual misoprostol versus 800μg vaginal misoprostol for early pregnancy medical abortion.Methods A total of 105 patients who underwent medical abortion in the Department of Obstetrics and Gynaecology,the University of Hong Kong-Shenzhen Hospital from October 1,2017 to October 30,2019 were selected.They were randomly divided into sublingual administration group(n=53)and vaginal administration group(n=52).After 200 mg mifepristone tablets for 48 h,misoprostol 400μg sublingual or misoprostol 800μg vaginal administration.The rate of pregnancy sac excretion,complete abortion rate,incomplete abortion rate,time of pregnancy sac excretion,duration of vaginal bleeding,amount of vaginal bleeding,pain score,duration of pain and adverse reactions of misoprostol were compared between 2 groups.Results There were no significant difference in the pregnancy sac discharge rate and complete abortion rate between 2 groups on the day of misoprostol application(P>0.05).The time from misoprostol to pregnancy sac in sublingual administration group was shorter than that in vaginal administration group(P<0.01).There were no significant differences in duration of vaginal bleeding,volume of vaginal bleeding,pain score,duration of pain and adverse reactions between 2 groups(P>0.05).Conclusion Both 400μg sublingual and 800μg vaginal administration of misoprostol can be used for medical abortion in early pregnancy,but 400μg sublingual administration of misoprostol in patients with faster pregnancy sac discharge,and sublingual administration of 400μg sublingual administration of misoprostol is convenient to use,while reducing the dosage of misoprostol,reduce the cost,it is worthy of further promotion.

关 键 词：药物流产 早孕 米索前列醇 米非司酮 舌下含服 阴道给药 

分 类 号：R169.42[医药卫生—公共卫生与预防医学]