米非司酮配伍前列腺素类三种方案终止孕10～16周妊娠的临床观察

CLINICAL OBSERVATION ON MIFEPRISTON FOR TERMINATION OF TEN TO SIXTEEN WEEK PREGNANCY WITH JOINT ADMINISTRATION OF PROSTAGLANDIN IN THREE WAYS

目的：探讨米非司酮配伍不同剂量、不同给药方法的前列腺素类终止孕１０～１６周妊娠的临床效果。方法：减少前列腺素类的剂量及延长给药间隔。分三组，Ａ组：米非司酮，首次５０ｍｇ，以后每１２小时口服２５ｍｇ，共４次，总剂量１５０ｍｇ；第３天晨口服米索前列醇０６ｍｇ，必要时６小时后再服一次。Ｂ组：米非司酮用法同Ａ组，第３天晨阴道放置卡孕栓１ｍｇ，必要时６小时后再放置１枚。Ｃ组：米非司酮，同上；第３天晨口服米索前列醇０４ｍｇ，每４小时１次，共３次。结果：三组有效流产率分别为９５３％、９２２％和８７５％，无显著性差异（Ｐ＞００５），前列腺素平均用量分别为０８７±０３ｍｇ、１４２±０５ｍｇ和０８６±０４ｍｇ，Ｂ组明显高于Ａ、Ｃ组，有非常显著性差异（Ｐ＜００１）。副反应发生率分别为２５０％、４６９％和１７２％，Ｂ组高于Ａ、Ｃ组（Ｐ＜００１）。结论：三种方案终止孕１０～１６周妊娠均获较好效果；Ａ组方案，有效率达９５２％，完全流产率高于Ｂ、Ｃ组，副反应轻，前列腺素用量少，值得推广。

OBJECTIVE: To study the clinical application of mifepriston for termination of ten to sixteen week pregnancg with joint administration of prostaglandin varying in dosage and route. METHOD: Every patient was given intitial dosage 50 mg mifepriston orally and 25 mg every twelve hours for four times, totally 150 mg. Afterwards, patients were divided into three group: group A: patients took 06 mg misoprostel on the third day morning and if necessary another dose may be taken 6 hours later. Group B: patients took vaginal suppository PG05 1 mg on the third morning and another dose may be taken 6 hours later. Group C: patients orally took misoprostel 04 mg and the same dose taken every 4 hours, total four doses. RESULTS: The rate of successful abortion for the three groups was 953%, 922% and 875% respectively and there was no significant difference among them (P>005). The dosage of prostaglandin in the three groups was 087±03 mg, 142±05 mg and 086±04 mg respectively, which group A was significantly higher than group B and C (P<001)。 25% patients in group A, 469% in group B and 172% in group C occured side effects, in which group B was higher than group A and C (P<001). CONCLUSION: The three ways have received good results, especially therapy in group A is highly efficient and less side effect as well as less dosage of prostaglandin than B, C. It is valuable to be spreaded.