利凡诺尔复合米非司酮、米索前列醇用于中期妊娠引产的临床效果

Outcomes of terminating medium-term pregnancy with rivanol combined use of mifepristone and misoprostol

目的观察利凡诺尔配伍米非司酮、米索前列醇用于中期妊娠引产的效果和安全性。方法确诊为16～27周的宫内妊娠自愿要求终止妊娠者76例分为两组:A组40例,应用利凡诺尔100mg羊膜腔内注射复合米非司酮150mg(均分两次,相隔12h)口服和米索前列醇600mg塞肛;B组36例,单纯利凡诺尔100mg羊膜腔内注射作为对照。记录用药前及口服米非司酮后Bisshop宫颈评分、记录两组临产发动时间、引产时间(注射药物至排胎时间),产后2h内出血量(用称重法)及药物不良反应。结果两组引产成功率均为100%。与B组比较,A组用药前后宫颈评分增加[(3.9±1.0)分vs.(6.1±1.1)分](P<0.01),而临产发动时间[(20.1±8.6)hvs.(14.2±6.2)h]、引产时间[(30.3±2.9)hvs.(23.4±2.6)h]及引产出血量[(80.5±32.7)mlvs.(20.1±26.3)ml]减少(P<0.01)。两组均无产后出血及术后感染病例;B组有4例轻度的恶心、乏力不适。结论利凡诺尔配伍米非司酮、米索前列醇引产有效,操作简便、安全,减少住院天数,同时也节省了费用。

Objective To observe the clinical outcomes of terminating medium-term pregnancy with rivanol combined use of mifepristone and misoprostol.Methods Seventy-six wemem with 16 to 27 weeks pregnancy who asked medium-term termination were divided into two groups.The patients in group A（40 cases） were injected rivanol 100 mg into amniotic cavity,which was followed by oral mifepristone 75 mg twice within 12 h and misoprostol 600 g put into the anus.The patients in group B（36 cases） were injected rivanol 100 mg into amniotic cavity only as the controls for induced abotion.Cervical Bisshop scores,placenta delivery time,amount of bleeding were recorded and compared between two groups.Results Success rate of abortion of two groups was 100%.Compared to group B,the cervical Bisshop score in group A was increased[（3.9±1.0） points vs.（6.1±1.1） points]（P0.01）,but placenta delivery time[（30.3±2.9） h vs.（23.4±2.6） h] and amount of bleeding[（80.5±32.7） ml vs.（20.1±26.3） ml] were all significantly less （P0.01）.Conclusion Terminating medium-term pregnancy with rivanol combined use of mifepristone and misoprostol is effective and safe with the advantages of simple use,less hospital stay and expense.