米索前列醇与米非司酮用于早孕人工流产软化宫颈的临床观察

Effect of misoprostol and mifepristone in softening the cervix of patients with early pregnancy( abortion)

目的观察米索前列醇与米非司酮在早孕人工流产术(人流术)术前软化宫颈的效果。方法选取92例早孕人流术患者,采用信封法随机分为2组,每组46例。米索前列醇组患者在无痛人流术前2 h口服0.4 mg米索前列醇,米非司酮组患者于无痛人流术前12h、2 h各服50 mg米非司酮。记录两组患者服药后腹痛、阴道流血等不良反应发生情况及宫颈软化程度,并观察两组中由于服药后阴道流血量多或出现明显腹痛而需要提前手术的例数。结果米非司酮组未发生阴道出血、腹痛及提前手术病例;米索前列醇组阴道出血率为8.69%,腹痛率为10.87%,提前手术率为4.34%。米非司酮组阴道出血率、腹痛率明显低于米索前列醇组(P<0.05);提前手术率略低于米索前列醇组,但差异无统计学意义(P>0.05)。米非司酮组宫颈充分软化率为76.09%,部分软化率为21.74%,软化不良率为2.17%;米索前列醇组分别为69.57%、28.26%、2.17%,两组比较差异无统计学意义(P>0.05)。结论米非司酮与米索前列醇用于早孕人流术术前对宫颈的软化效果相同,但米非司酮不良反应发生率低,临床应用前景更为广阔。

Objective To observe the preoperative cervical softening effect of misoprostol and mifepristone on abortion patients with early pregnancy. Methods 92 abortion patients with early pregnancy were randomly divided into two groups using the envelope methods, Misoprostol group（ n = 46 ）was given 0.4 mg misoprostol orally at 2 h before the operation, mifepristone group （n = 46 ）was given 50 mg mifepristone at 12 h and 2 h before the operation. The abdomen pain, vaginal bleeding and other adverse events and the degree of cervical softening were recorded. The number of patients who had large amount of vaginal discharge or significant abdominal pain due to the medication and require surgery in advance was observed. Results No case of vaginal bleeding, abdominal pain and early surgery was found in mifepristone group. In misoprostol group, the rates of vaginal bleeding, abdominal pain and early surgery were 8.69% , 10.87% and 4.34%. The rates of vaginal bleeding and abdominal pain of mifepristone group were significantly lower than those of misoprostol group（ P 〈 0.05 ） , there was no significant difference in early surgery rate between the two groups（P 〉0.05）. The fully soften rate of cervix in mifepristone group was 76.09% ,and partial soften rate was 21.74% , adverse soften rate was 2. 17% ; and they were 69. 57% , 28. 26% , 2. 17% in misoprostol group （ P 〉 0.05 ）. Conclusion The preoperative cervical softening effect of mifepristone and misoprostol on abortion（ early pregnancy） is the same, but mifepristone has lower incidence of adverse effects with broader prospects of clinical use.