雌激素结合米非司酮与米索前列醇及清宫术治疗胚胎停止发育的临床效果  

Clinical Effects of Estrogen Combined with Mifepristone and Misoprostol,as Well as Curettage in the Treatment of Embryonic Arrest

作　　者：张华芝 ZHANG Huazhi(Department of Obstetrics and Gynecology,Shunchang Hospital of Traditional Chinese Medicine,Nanping,Fujian 353200,China)

机构地区：[1]顺昌县中医院妇产科,福建南平353200

出　　处：《中国医药指南》2025年第6期96-98,共3页Guide of China Medicine

摘　　要：目的分析雌激素联合米非司酮、米索前列醇及清宫术方案在胚胎停育治疗中的临床应用效果。方法在2022年1月至2023年1月顺昌县中医院妇产科筛选了130例接受清宫术治疗的胚胎停止发育患者,用随机数字表法分为联合治疗组与对照组,各65例。对照组实施米非司酮联合米索前列醇及清宫术的综合治疗,联合治疗组在对照组的基础上结合雌激素治疗,比较两组患者临床疗效、缩宫素剂量、胚胎排除时长、阴道持续流血时间、HCG转阴率和月经复潮时间、子宫恢复情况、血清因子水平、不良反应发生情况。结果清宫成功率联合治疗组高于对照组(P<0.05);联合治疗组HCG转阴率高于对照组(P<0.05),月经复潮时间两组比较无统计学意义(P>0.05);治疗后较治疗前两组同型半胱氨酸(Hcy)、白细胞介素4(IL-4)、低氧诱导因子1α(HIF-1α)水平均降低,且联合治疗组低于对照组(P<0.05);两组不良反应发生率比较无统计学意义(P>0.05)。结论雌激素结合米非司酮、米索前列醇及清宫术疗法在胚胎停育治疗中具有显著的临床效果,优化子宫状况,控制炎性因子水平,安全性良好。Objective To analyze the clinical application effect of estrogen combined with mifepristone,misoprostol,and curettage in the treatment of embryonic arrest.Methods In the Department of Obstetrics and Gynecology of Shunchang County Hospital of Traditional Chinese Medicine from January 2022 to January 2023,130 cases of embryo arrest patients receiving uterine ablation treatment were screened and divided into the combined treatment group and the control group by random number table method,with 65 cases each.The control group received a comprehensive treatment of mifepristone combined with misoprostol and curettage,while the combination therapy group received estrogen treatment on the basis of the control group.The clinical efficacy,oxytocin dosage,embryo exclusion time,duration of vaginal bleeding,HCG conversion rate and menstrual regain time,uterine recovery,serum factor levels,and incidence of adverse reactions were compared between the two groups of patients.Results The success rate of curettage in the combined treatment group was higher than that in the control group(P<0.05).The HCG conversion rate in the combination therapy group was higher than that in the control group(P<0.05),and there was no significant difference in the time of menstrual recurrence between the two groups(P>0.05).After treatment,the levels of homocysteine(Hcy),interleukin-4(IL-4),and hypoxia inducible factor 1α(HIF-1α)decreased in both groups compared to before treatment,and the combined treatment group was lower than the control group(P<0.05).There was no statistical significance in the incidence of adverse reactions between the two groups(P>0.05).Conclusions The combination of estrogen,mifepristone,misoprostol,and curettage therapy has significant clinical effects in the treatment of embryonic arrest,optimizing uterine condition,controlling inflammatory factor levels,and ensuring good safety.

关 键 词：胚胎停止发育 清宫术 雌激素 米非司酮 米索前列醇 

分 类 号：R714.2[医药卫生—妇产科学]