米非司酮配伍米索前列醇治疗稽留流产的疗效观察

Clinical effect of mifepristone combined with misoprostol on missed abortion

目的：观察米非司酮配伍米索前列醇治疗妊娠10 ～ 16周稽留流产的疗效,探讨可行性及安全性.方法：收集经B超确诊的孕10～16周稽留流产妇女150例（稽留流产组）,要求终止妊娠的10 ～16周正常妊娠者80例（正常妊娠组）,两组均采用米非司酮配伍米索前列醇进行药物流产,比较两组治疗效果、清宫率、阴道出血量及不良反应.结果：稽留流产组完全流产121例（80.7％）,不全流产23例（15.3％）,无效6例（4.0％）;正常妊娠组完全流产70例（87.5％）,不全流产9例（11.3％）,无效1例（1.3％）,两组疗效差异无统计学意义（Z=-1.359,P＞0.05）;稽留流产组清宫率（19.33％）与正常妊娠组（12.50％）比较无统计学差异（x2=1.730,P＞0.05）,阴道流血量（68.24±27.62ml）高于正常妊娠组（46.81 ±23.37ml）（t=9.147,P＜0.05）;两组不良反应出现情况无明显差异.结论：米非司酮配伍米索前列醇治疗稽留流产的疗效与终止相同孕周正常妊娠疗效相当,除阴道流血量略高于正常妊娠组外,未增加清宫率与不良反应,具有可靠的疗效与安全性.

Objective：To explore the clinical effect of mifepristone combined with misoprostol on missed abortion.Methods：A total of 230 women with 10-16 weeks of gestation ages were recruited,including 150 women with missed abortion （study group） and 80 women experiencing normal pregnancy （control group）.Mifepristone and misoprostol were used for medical abortion.The curative effect,vacuum aspiration rate,the amount of bleeding and the incidence of side effects were evaluated.Results：A total of 121 （80.7％） complete abortion,23 （15.3％） incomplete abortion and 6 （4.0％） invalid were found in the study group and 70 （87.5％） complete abortion,9 （11.3％） incomplete abortion and 1 （1.3％） invalid were found in the control group.There was no significant difference in the curative effect between the two groups （Z =-1.359,P ＞ 0.05）.The vacuum aspiration rate were 19.33％ and 12.50％ in the study group and the control group,respectively,showing no significant difference （x2 =1.730,P ＞ 0.05）.The amount of vaginal bleeding in the study group was 68.24 ± 27.62 ml,more than that of the control group （46.81 ± 23.37ml,t =9.147,P ＜ 0.05）.There was no significant difference in the incidence of side effects between the two groups.Conclusion：Mifepristone combined with misoprostol could be used for the treatment of missed abortion.