米索前列醇3种给药途径用于无痛人工流产术前扩张宫颈的疗效比较

Efficacy Observation of 3 Kinds of Route of Administration of Misoprostol for Cervical Dilatation before Painless Artificial Abortion

目的：比较米索前列醇3种给药途径用于无痛人工流产术前扩张宫颈的疗效和安全性。方法：将159例自愿要求行无痛人工流产术终止妊娠的孕早期妇女按随机数字表法分为A、B、C组，每组53例，分别于术前3h舌下含服、口服、阴道后穹窿放置米索前列醇0．4mg，并采用异丙酚2～3mg／kg麻醉，观察3组患者的宫颈扩张程度、手术时间、术中出血量、镇痛效果及不良反应发生情况。结果：3组患者的宫颈扩张程度、手术时间、术中出血量及镇痛效果比较，差异均无统计学意义（P〉0．05）。A、C组患者的恶心呕吐、腹泻发生率明显低于B组，差异有统计学意义（P〈0．05）；3组患者术前阴道流血和腹痛的发生率比较，差异均无统计学意义（P〉0．05）。结论：无痛人工流产术前3h舌下含服、口服、阴道后穹窿放置米索前列醇0．4mg用于扩张宫颈的疗效相似。舌下含服用药消化道不良反应发生率低，但对于含药感不好的患者可口服用药，而阴道用药则更适合于妊娠反应重、胃肠功能差的患者。临床用药时可根据患者的不同情况选择给药途径。

OBJECTIVE： To investigate the route of administration of misoprostol for cervical dilatation before painless artifi- cial abortion. METHODS： 159 women underwent voluntary painless artificial abortion in early pregnancy were randomly divided into group A, B, C with 53 patients in each group. They were given sublingual, oral, vaginal fomix misoprostol 0.4 mg 3 h before painless artificial abortion, and diprivan 2-3 mg/kg for anesthesia; cervical dilatation, operation time, blood loss and adverse drug reaction were observed in 3 groups. RESULTS： There was no statistical significance in degree of cervical dilatation, operative time and blood loss among 3 groups （P〉0.05） ; the incidence of nausea, vomiting and diarrhea in group A and C were significantly lower than in group B; there was statistical significance （P〈0.05） ; there was no statistical significance of the indence of the vaginal bleeding and abdominal pain before surgery and stomachache among 3 groups （P〉0.05）. CONCLUSIONS： 3 h before painless artificial abortion, sublingual, oral, vaginal fornix misoprostol 0.4 mg have similar therapeutic efficacy for cervical dilatation; the incidence of side effects is low with sublingual administration, and vaginal medication is suitable for the patients with severe pregnancy reaction and poor gastrointestinal function.