米非司酮用于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:观察在稽留流产清宫前,应用米非司酮配伍米索前列醇的临床效果。方法:将38例稽留流产患者随机分为两组。观察组17例,术前1 d口服米非司酮100 mg术前3h阴道放置米索前列醇200μg;对照组21例,术前口服乙烯雌酚5 mg每日3次,连续给药5 d,行钳刮术。结果:观察组宫口扩张有效率100%,(17/17)明显高于对照组33%(7/21)。观察组1例,在钳刮术后清宫一次(6%),对照组在钳刮术后清宫一次11例(52%),行两次清宫2例(9.5%)。观察组出血量≤50 ml 14例(82%),50~100 ml 3例(18%);对照组出血量≤50 ml 10例(47%),50~100 mL9例(42%),出血量100 ml^200 ml 2例(9.5%)。观察组无一例发生人工流产综合反应。对照组5例发生人工流产综合反应。结论:稽留流产清宫前应用米非司酮配伍米索前列醇,扩宫口作用肯定,出血量少,不良反应轻,优于术前应用乙烯雌酚。

Objective： To evaluate the efficacy of mifepristone and misoprostol combined with on missed abortion. Methods： Thirty-eight patients with missed abortion were divided into observation group and control group randomly. The observation group of seventeen cases was given mifepristone 100 before operation day before operation and 200 μg in the vagina 3h before operation. 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 diethy lstilbestro; still boestrol 5mg every time, 3 times per day for 5 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.