阴道放置米索前列醇及卡孕栓在早期人工流产术前的应用

Applications of vaginal misoprostol and PG05 in the termination of the first-trimester pregnancy.

目的:评价米索前列醇(简称米索)及卡孕栓在早期妊娠人工流产术前阴道用药的宫颈扩张作用。方法:400μg米索或1mg卡孕栓被术前2～5小时分别放置妊娠5～10周妇女阴道后穹窿内,记录每例患者宫颈的扩张程度及腹痛、出血等副作用。结果:当药物作用3.5小时以内时,两组宫颈扩张作用的差异尚不明显。3.5小时后卡孕栓扩张宫颈的作用则明显优于米索。阴道内术前用药超过3.5小时无论米索组或卡孕栓组与其自身比较,宫颈扩张的作用均较用药3.5小时以内的作用明显提高。卡孕栓组较米索组腹痛等胃肠道副反应的发生率高。结论:米索及卡孕栓在早期妊娠人工流产术前阴道用药有较强的宫颈扩张作用。米索副作用相对较少,适于人工流产前的宫颈扩张的常规用药。妊娠天数较长,胚胎较大,人流手术相对困难者使用卡孕栓较为合理。上述药物术前阴道使用推荐时间为至少3.5小时。

Objective: To evaluate the effects of vaginal misoprostol and PG05 applications for the cervical dilatation in the early pregnancy interruption. Methods : 400μg misoprostol and 1mg PG05 were applied into the posterior fornix of 50 women with the gestational age of 5 to 10 weeks respectively. All cases were examined 2 to 5 hours latter. The cervical dilatation,extrauterine cervical bleeding and the side-effects were investigated. Results :In the PG05 group the dilatation of cervix was significantly larger than that of the misoprostol group. In 24% of the cases nausea,in 78% abdominal pain,in 14% diarrhea were detected in women of the misoprostol group,while in 52% of the cases nausea,in 94% abdominal pain,and 76% diarrhea were detected in women of the PG05 group. Conclusion: Vaginal application of the misoprostol and PG05 could reduced the damage of cervix during the artifical abortion by its facilitating effect on the cervical dilatation. Vaginal misoprostol could be served as a routine application for the cervical dilation in the early pregnancy interruption. Vaginal PG05 could be used in a larger and more difficult artificial abortion procedure. The recommended time for the above drugs vaginaly was at least 3. 5 hours prior to the operation.