米非司酮配伍米索前列醇不同方案行早孕药物流产的疗效

Efficacy of different dosage regimen of mifepristone combined with misoprostol for medicine abortion at early pregnancy

目的探究米非司酮配伍米索前列醇不同方案行早孕药物流产的疗效。方法选取2013年1月至2017年12月宁波市镇海龙赛医院诊治的自愿要求终止妊娠早孕患者120例作为研究对象。按照入院顺序分为对照组和观察组实施对比研究,每组60例,对照组给予米非司酮一次顿服治疗方案,先给予患者顿服米非司酮,每次25mg,每日3次,连续服用3d,并在用药1d后联合服用米索前列醇3片,0.2mg/片。观察组给予米非司酮分次服用方案,首先给予患者清晨空腹情况下服用米非司酮,每次50mg,每日3次。服药后观察8 h～12h,并禁食2h,之后指导患者于空腹情况下服用米非司酮25mg。用药第二天,给予患者口服米非司酮,每次25mg,早晚各服用1次。用药第3d,早晨空腹情况下,服用25mg米非司酮。服药1h后,给予患者服用米索前列醇3片0.2mg/片。观察2组患者的完全流产率、用药后阴道开始流血时间与开始宫缩时间、不良反应发生率等实验数据。结果观察组的完全流产率为93.33%,显著高于对照组的83.33%,差异具有统计学意义(P<0.05)。用药后观察组患者阴道开始流血时间与开始宫缩时间分别为(28.12±5.13)h、(29.12±3.25)h,均显著短于对照组的(31.12±5.35)h、(31.15±2.03)h,差异具有统计学意义(P<0.05)。两组用药后均出现一定的不良反应,包括恶心、腹泻等,对照组的不良反应发生率为6.67%,高于观察组的5.00%,但组间比较均无统计学差异,(均P>0.05)。结论米非司酮配伍米索前列醇行早孕药物流产过程中,两种药物联合应用可发挥出理想的协同效果,且米非司酮分次服用可获得更好的治疗效果,起效时间更短,完全流产率更高,不良反应发生率更低。

Objective To explore the efficacy of different dosage regimen of mifepristone combined with misoprostol formedicine abortion atearly pregnancy. Methods 120 patients with early pregnancy who received induced abortion voluntarilyin Zhenhai Longsai Hospital of Ningbo from January 2013 to December 2017 were divided into observation group and control group, with 60 cases in each group. The control group was given single oral dose regimenof mifepristone, 25mg per time,3 times a day, for three day and at a day after taking misoprostol tablets,the control group started taking3 tablets of misoprostol, 0. 2mg/tablets. The observation group received divideddose regimen. Firstly, the observation group took 50mg mifepristone on empty stomach at early morning. After 8 ~ 12h and fasting 2h, they took 25mg mifepristone. At the second day of medication, they took 25mg mifepristone once in the morning and once at night. At the third day of medication, they took 25mgmifepristoneon empty stomach at early morning, and lh later they took 3tablets of misoprostol. The total abortion rate, time of vaginal bleeding, time of u- terine contraction and incidence of adverse reactions in the two groups were observed. Results The rate of complete abortion in observation group (93. 33%) was significantly higher than that of control group (83. 33%), with statisticallysignificantdifference ( P < 0. 05 ). After treatment, the time of vaginal bleeding and time of contractions in observation group were (28. 12 ±5. 13) h and (29. 12 ±3.25) h, respectively, which were significantly shorter than the control group of (31. 12 ±5. 35) h and (31. 15 ±2. 03) h accordingly, with statistically significant differences (P <0. 05). The two groups had some adverse reactions after treatment, including nausea and diarrhea. The incidence of adverse reactions in control group (6. 67 %) was higher than that in observation group (5 %), with no statisticallysignificant difference between two groups ( P > 0. 05 ). Conclusions Mifepristone combined with misoprostol has synergistic effect in medicine abortion, and divided dose regimen of mifepristone can obtain better curative effect, with shorter onset time, higher complete abortion rate and lower incidence of adverse reaction.