米非司酮与米索前列醇联合用于终止中期妊娠的临床分析

Combined use of mifepristone and misoprostol in the termination of second trimester pregnancy

目的:观察口服米非司酮联合米索前列醇阴道给药终止中期妊娠的临床效果及安全性。方法:选择我科自2009年5月～2012年4月收治的118例中期妊娠患者并随机分为两组,59例患者采用依沙吖啶羊膜腔内注射引产作为对照组,59例患者采用米非司酮联合米索前列醇引产作为观察组,观察比较两组患者引产效果及不良反应发生情况。结果:59例观察组患者,52例(88.14%)完全流产,6例(10.17%)不全流产,1例流产失败转钳刮术;对照组患者50例(84.75%)完全流产,7例(11.86%)不全流产,2例(3.39%)流产失败,两组差异无统计学意义。两组患者引产后阴道出血量经比较也无显著差异。两组患者均有不同程度腹痛,部分观察组患者表现为恶心、呕吐等消化道不良反应,少数对照组患者表现为体温升高,未经处理症状体征均消失。观察组孕产物排出平均时间(6.8±2.3)h;对照组平均时间为(30.6±6.8)h,两组差异具有统计学意义(P<0.05)。结论:米非司酮联合米索前列醇作为一种非侵入性终止妊娠手段,应用于终止中期妊娠,引产效果好,引产时间明显缩短,而且操作简单、无创伤,更乐于被患者所接受。

Objectives： To observe the clinical efficacy and safety of mifepristone combined with misoprostol vaginal deliv- ery in the termination of second trimester p~＇egnancy. Methods： A total of 118 patients in their second trimester pregnancy were randomly divided into two groups who were admitted into our department from May 2009 to April 2012. Fifty - nine patients in the control group were labor induced by intra - amniotic injection of Ethacridine, while another 59 cases in the observation group were treated with Mifepristone and misoprostol for the induction of labor. The two groups were observed and compared in their labor in- duction results and adverse reactions. Results： Among 59 patients in the observation group, 52 （ 88. 14% ） had complete abor- tion, 6 cases （ 10. 17% ） had incomplete abortion, 1 case failed in the drug - induced abortion, then resorting to curettage abor- tion; In the control group, 50 （84. 75% ） cases had complete abortion, 7 （11.86 % ） cases had incomplete abortion, 2 （3. 39% ） cases failed in the abortion. The difference between the two groups was not statistically significant. The two groups showed no differences in the amount of vaginal bleeding. Both groups have varying degrees of abdominal pain, The average time for pregnancy product discharge in the observation group is （ 6. 8 ±2. 3 ） h; while the average time in control group was （ 30. 6 ± 6. 8） h. The difference was statistically significant （ P 〈 0. 05）. Conclusion： Mifepristone combined with misoprostol, as a non - invasive method for pregnancy termination, was effective and efficient in the termination of second trimester pregnancy. It great- ly shorten the induction duration, causing little pain for patients, and therefore, it is more simple and acceptable to patients