循证医学与早孕终止妊娠方法的选择

Evidence-based medicine and therapeutic choices of early prehnancy termination

目的通过分析对比早孕终止妊娠的不同方法,探讨其方法选择,为临床咨询提供详实的方案。方法收集本院2008年自愿选用药物流产1 013例,自愿选用无痛人流2 424例,对比流产时出血量、术后流血及腹痛天数,并对两组用药方案进行研讨。结果药物流产组流产时出血量、流产后阴道流血天数及24h内的腹痛程度均大于无痛人流组,差异有显著性(P<0.05)。结论尽管无痛人流的预后明显优于药物流产,但实施难度大,且风险也大,并基于约40%的人群选用药物流产,提示不同方法有不同的适应症。医生应按循证医学原则,充分提供咨询并与早孕妇共同确定流产方式,尽可能减少流产者的心身伤害和经济负担。

Objective To explore therapeutic choices of early pregnancy termination by comparing and analyzing different therapeutic methods as to provide accurate and practical therapy for clinical consultation. Methods Data of 1 013cases of voluntary drug abortion and 2 424 cases of voluntary painless induced abortion was collected to compare the amount of abortion bleeding,postoperative bleeding and days of abominable pain.Meanwhile,drng using programs of the two groups were also discussed. Results The amount of abortion bleeding,the days of postoperative vaginal bleeding and abominable pain within 24 hours of painless induced abortion group were all more serious than drug abortion group,and the difference is statistically significant （P〈0.05）. Conclusion Although the prognosis of painless induced abortion is clearly superior to that of drug abortion,it＇t difficult to implement and more risky. Based on the fact that 40% patients opt for drug abortion, it is suggested that different therapy should be adopted to different indications. In light of Evidence Based Medicine doctors should provide sufficient consultation and deicide on abortion method with early pregnancy patients to reduce the physical and psychological injury as well as the economical burden to them..