米非司酮与米索前列醇、戊酸雌二醇治疗稽留流产疗效比较

The treatment efficacy of mifepristone plus misoprostol vs estradiol valerate in missed abortion

目的:探讨清宫术分别联合米非司酮、米索前列醇与戊酸雌二醇治疗稽留流产的疗效。方法:选取2018年1月至2019年1月东莞市人民医院收治的100例稽留流产患者作为研究对象,按治疗方案的不同分为三联组(50例)和二联组(50例)。三联组采用米非司酮、米索前列醇联合清宫术治疗,二联组采用戊酸雌二醇联合清宫术治疗。比较两组手术效果、手术情况(一次性清宫成功率、出血量、手术时间、月经复潮时间)、人工流产综合征发生率等指标。结果:三联组总有效率为98.00%(49/50),高于二联组的84.00%(42/50)(P<0.05);三联组一次性清宫成功率为96.00%(48/50),高于二联组的70.00%(35/50),出血量、手术时间、月经复潮时间均少于二联组(P<0.05)。结论:与戊酸雌二醇联合清宫术相比,米非司酮、米索前列醇联合清宫术治疗稽留流产效果更佳,能有效减少术中出血量,缩短恢复时间。

Objective:To investigate the treatment efficacy of uterine curettage combined respectively with mifepristone plus misoprostol or estradiol valerate in missed abortion.Methods:A total 100 patients with missed abortion admitted to Dongguan People’s Hospital between January 2018 and January 2019 were enrolled as subjects.According to the treatment option,they were divided into the triple therapy group(n=50)and dual therapy groups(n=50).The triple therapy group received mifepristone and misoprostol combined with uterine curettage,and the dual therapy group was treated with estradiol valerate combined with uterine curettage.The treatment outcomes and surgery(rate of successful curettage in one attempt,blood loss,operation time,time to recovery of menstrual cycle),and incidence of induced abortion syndrome were compared between groups.Results:The total effective rate in the triple therapy group was 98.00%(49/50),which was higher than the84.00%(42/50)in the dual therapy group(P<0.05).Compared with the dual therapy group,the triple therapy group showed higher rate of successful curettage in one attempt[96.00%(48/50)vs 70.00%(35/50)],less blood loss,shorter operation time,and quicker time to recovery of menstrual cycle(P<0.05).Conclusion:Compared with estradiol valerate combined with uterine curettage,mifepristone plus misoprostol combined with uterine curettage are better for treatment of missed abortion in terms of effectively reduced blood loss and shortened recovery time.