米非司酮配伍米索前列醇终止10～14周妊娠的临床应用

The clinical application about termination of 10～14 weeks gestation with mifepristone plus misoprostol

目的 探讨米非司酮配伍米索前列醇终止 1 0～ 1 4周妊娠的最佳用药途径及效果。方法 将 1 4 6例妊娠 1 0～ 1 4周要求终止妊娠的妇女随机分成 2组。Ⅰ组 (80例 ) ,口服米非司酮 2 5mg,每日 2次 ,首剂加倍。第 3天晨服米索前列醇 ,每次 0 6mg ,最多 3次 ;Ⅱ组 (6 6例 )米非司酮用法同Ⅰ组 ,第 3天晨阴道内放置米索前列醇每次 0 6mg ,最多 3次。 结果 Ⅱ组流产成功率高于Ⅰ组差异有显著性 (P <0 0 5 ) ;流产时出血量差异无显著性 (P >0 0 5 ) ,流产同时行清宫者阴道流血时间明显短于完全流产未行清宫者 ,且以后再次清宫发生率低于后者 ,差异均有显著性 (P <0 0 1 )。结论 口服米非司酮配伍阴道放置米索前列醇是终止 1 0～ 1 4周妊娠的一种理想方法 。

Aim To find out the optimal regimen of mifepristone plus misoprostol for termination 10～14 weeks gestation and it's efficiency.Methods A randomized comparative study was conducted in 146 women requesting medical abortion at 10～14 weeks gestation in my hospital. They were divided into two groups. Group I( n =80) took mifepristone 25 mg orally bid, double dose at first and 48 h later misoprostol 0 6 mg orally every time, no more than three times. Group II( n =66) took same dose of mifepristone as in group I and 48 h later misoprostol 0 6 mg given vaginally every time and no more than three times.Result The abortion rate of group II was higher than that in group Ⅰ ( P <0 05), but no significant difference of the bleeding volume ( P >0 05). The time of vaginal bleeding of abortion with curratage was shorter than that in the complete abortion without curratage and the incidence of the recurratage was lower than the later ( P <0 01).Conclusion Mifepristone plus misoprostol given vaginally is an optimal method for termination of 10～14 weeks gestations. Instantly, curratage is necessary ever for the complete abortion.