米非司酮和米索前列醇配合清宫术治疗稽留流产的临床观察

Clinical effect of mifepristone and misoprostol combined with the operation of clearing uterus on missed abortion

目的评价口服流产药物配合清宫术治疗稽留流产的疗效。方法120例稽留流产患者随机分为观察组和对照组,每组60例。观察组口服米非司酮,第1天早晨7时50 mg,晚上7时25 mg,第2天同法服用,第3天早晨7时米索前列醇0.6 mg顿服,观察阴道出血如月经量或胚胎组织排出后,行清宫术。对照组口服乙烯雌酚片,每次5 mg,每日3次,连续服用5 d,行清宫术。观察2组患者术中镇痛效果、宫颈软化及扩张程度、手术时间、术中出血量、人流综合征发生率、服药后胚胎自然排出率及1次清宫成功率。结果观察组术中镇痛有效率、胚胎自然排出率及1次清宫成功率均高于对照组(P<0.05),宫颈软化及扩张程度优于对照组(P<0.05),手术时间、术中出血量及人工流产综合征发生率均低于对照组(P<0.05)。结论米非司酮、米索前列醇配合清宫术治疗稽留流产安全、实用、效果好,值得临床应用。

Objective To evaluate the efficacy of abortive medicine combined with on missed abortion. Methods One hundred and twenty patients with missed abortion were divided into observation group and control group randomly, each group was 60 cases. The observation group was given mifepristone 50 mg in 7 o＇clock and 25 mg in 19 o＇clock in the 1^st and 2^nd day,in the 3rd day was given misoprostol 0.6 mg to take at a draught in 7 o＇clock. Then took the operation of clearing uterus when vaginal hemorrhage volume was as menstrual blood volume or embryonic tissue was discarded. The control group was given diethylstilbestrol ; stillboestrol 5mg every time ,3 times per day for 3 days. Then took the operation of clearing uterus. Analgesia effect, degree of softening and extension of cervix, operation time, hemorrhage volume, incidence of induced abortion syndrome, the rate of embryonic effluence and achievement ratio of clearing uterus with one time were observed between two groups. Results Effective power of analgesia ,the rate of embryonic effluence and achievement ratio of clearing uterus with one time in observation were higher than in control group（ P 〈 0.05 ）. The degree of softening and extension of cervix had an advantage of control group（ P 〈 0.05 ）, operation time ,hemorrhage volume and incidence of induced abortion syndrome were lower than in control group （P 〈 0.05 ）. Conclusion Mifepristone and misoprostol combined with the operation of clearing uterus on missed abortion is safe and useful, the efficacy is good. It is value to apply in clinic.