米非司酮对人工流产术后宫腔残留的临床疗效分析

Clinical efficiency of mifepristone in the treatment of intrauterine residual after induced abortion

目的研究米非司酮对人工流产术后宫内残留的临床疗效及不同给药方案之间的疗效差异。方法选取2011年12月～2013年3月本院妇产科门诊中121例自愿流产患者，以阴道流血时间、血B—HCG值和B超检查为纳入标准，随机双盲分成3组。对照组予以益母草和抗菌药，研究组除此以外加服不同剂量的米非司酮（25mg和100mg）。通过B超、内分泌指标检测和临床观察，比较米非司酮对人流术后残留的疗效及不同给药方案之间的差异。结果米非司酮研究组和对照组的清宫发生率分别为33．33％和81．40％，具有明显的统计学差异（P〈0．01）。米非司酮给药2周后的宫内残留组织在2个研究组间的差异有统计学意义（P〈0．05），短时大剂量组的血B—HCG下降更为明显、宫内残留物缩小范围更大；给药2周后B超和血B—HCG值提示，研究组明显优于对照组，有统计学意义（P〈0．01），其中短时大剂量组疗效最突出；给药4周后的血B—HCG值在两研究组间差异无统计学意义（P〉0．05）。3组的阴道流血时间差异有统计学意义（P〈0．05），但大剂量组和小剂量组在愈合时间上差异无统计学意义（P〉0．05）。研究组的不良反应发生率差异无统计学意义（P〉0．05）。结论应用米非司酮治疗人工流产术后宫内残留可减少术后阴道流血时间，避免清官发生，且短时大剂量给药更为有效。

Objective To evaluate the efficiency of mifepristone in treating intrauterine residual after induced abortion and compare the different ways of administrating mifepristone. Methods A total of 121 outpatients who accepted induced abortion at their own will were randomly divided into 3 groups with inclusion criteria of vaginal bleeding time, [3 -HCG in blood and type-B ultrasonic examination.Motherwart and antibiotics were given to controlled group. Except from the same administration as controlled group,the other two groups were arranged to take different dosages of mifepristone （25mg and 100mg）.Via examination of type-B ultrasonic,endocrine indexes detection and clinical observation, the efficiency of mifepristone in treating intrauterine residual after induced abortion and different ways of administrating mifepristone were evaluated. Results Incidences of clear palace operation from the groups mifepristone was administrated to and the controlled group were respectively 33.33% and 81.40%,which indicated significant statistical difference（P 〈 0.01）.After 2 weeds of applying mifepristone,significant statistical difference was discovered between two mifepristone groups（P 〈 0.05） and the group whose administration way was shorter time and larger dosage showed more efficient.In 2 weeks after administration, typ-B ultrasonic and blood 13 -HCG results validated that mifepristone groups were better compared to the controlled group with significant statistical difference（P 〈 0.01）.The shot-time and large-dosage group were the outstanding as well. Opposite to comparison between 3 groups（P 〈 0.05）,no significant statistical difference was found between the two mifepristone groups（P 〉 0.05）.Furthermore,comparison between groups of large dosage and small dosage demonstrated no significant statistical difference（P 〉 0.05）,the same as untoward effect（P 〉 0.05）. Conclusion Application of mifepristone in the treatment of intrauterine residual after induced abortion is able to reduce vaginal bleeding time and prevent clear palace operation. Moreover,administration with short time and large dosage is more efficient.