米索前列醇在妇产科临床的应用

Application of Misoprostol in clinical Gynaecology

米索前列醇是人工合成的前列腺素E1的衍生物,有多方面的临床用处,20世纪80年代早期米索前列醇最先用于消化性溃疡,80年代以后米索前列醇与米非司酮配伍用于抗早孕,可使完全流产率大大提高。近几年广泛应用于妇产科领域,如人工流产、上环、取环、诊断性刮宫、术前或口服阴道用药,起到扩张宫颈的作用,减少受术者的痛苦。米索前列醇用药中期引产,局部用药增加引产的效果,死胎引产成功率可达百分之百;用于足月妊娠诱发宫缩可缩短产程,预防剖宫产术后出血;治疗产后大出血有明显的效果。米索前列醇的主要作用是促进宫颈成熟,诱导分娩,减少产后出血,给药途径不同,产生的效果也不相同,口服吸收迅速,30min达到血药浓度高峰,血浆清除半衰期为1.5h,局部用药副作用小、吸收快,直接作用于宫颈。米索前列醇具有应用简便、效果可靠、易掌握、安全、副作用小、价格低的特点,适用于各级医院,尤其是基层医院,对减少产后出血的发生率,减低孕产妇死亡率,减少出血用量均有重要意义。

Misoprostol is the derivatives of synthesized prostaglandin E1 and has a wide range of application in clinics.It is used in the treatment of digestive ulcer in the early 1980s,and then combined with Mifepristone in the prevention of early pregnancy and abortion in the late 1980s.In recent years,misoprostol is widely used in gynaecology and obstetrics,such as artificial abortion,putting-in and taking-out of intrauterine device,diagnostic dilatation and curettage,pre-operational vaginal medication for the purpose of cervix dilatation and pain relieving.In the case of middle-term pregnancy termination,local administration of misoprostol could improve the efficacy of termination,and ensure the 100% termination success rate.When misoprostol is used in full-term delivery,it can stimulate Uterine Spasm,shorten delivery process,and prevent the hemorrhage after cesarean section.It can also have good effects on the treatment of postpartum hemorrhage.In conclusion,the main function of misoprostol is to accelerate cervix maturity,to facilitate delivery,to reduce the risk of postpartum hemorrhage.The effects of misoprostol can be different in accordance with different medication means.Oral medication could lead to quick absorption,reaching highest drug concentration after 30 minutes,and having 15 hours of elimination half-life.Local medication can be directly applied to cervix,producing smaller side effects and quick absorption rate.Use of misoprostol is convenient,reliable,safe,inexpensive and low in side effects,and therefore is suitable for application in gynaecology and obstetrics.