不同溶剂湿化的米索前列醇阴道给药用于人工流产术前宫颈扩张随机对照研究

A Comparative study on the Misotprostol Dissolved by Different Medium Administrated Intravaginaliy Before Surgi-cal Abortion in Primigravidae.

目的:探讨不同溶剂湿化的米索前列醇阴道给药对宫颈扩张的疗效。方法:选择停经<60天,自愿选用负压吸宫术终止妊娠的健康初孕妇女,随机分为3组,Ⅰ组(固态米索组),28例,Ⅱ组(氯化钠湿化组),30例,Ⅲ组(醋酸湿化组),30例,3组对象置药3小时后,行负压吸宫术。观察:①阴道药片溶解情况;②宫颈扩张度;③术中出血量;④置药后副反应。结果:①各组临床特征比较差异无显著性(P>0.05);②3组有效宫颈扩张度比率Ⅱ组、Ⅲ组分别与Ⅰ组比较,具有显著性差异(P<0.01),而Ⅱ、Ⅲ组间相比较,差异无显著性(P>0.05);③阴道药片溶解情况,Ⅰ组中,完全溶解例数0,Ⅱ组与Ⅲ组完全溶解例数无差异,其残留药物粉状,量少;④各组术中出血量及副反应发生率差异无显著性(P>0.05)。结论:米索湿化使得阴道粘膜易于吸收,宫口扩张效果增强,但醋酸并不进一步增加入流术前宫颈扩张的效果。氯化钠湿化是最佳途径。

Objective: To determine the efficacy of vaginal misoprostol dissolved by different medium for pre abortion dilatation of the cervix. Methods:88 nulliparous women with early pregnancy were divided randomly into three groups. Group misoprostol table in solid state(28 case),Group misoprostol table dissovled by sodium chloride (30 case)and Group misoprostol table dissolved by acetic acid. (30 case). vacume aspiration was performed 3 hours after insertion of the misoprostol table dissolved by different medium. The rate of the effective cervical dilatation (7. 0mm). the amount of dissolved misoprostol in vagine,the amount of the vaginal bleeding during the operation and the side effects of miso-prostol were observed. Results : 1 there is no difference in clinic characteristic among three groups 2. the rate of the ef-fective cervical dilatation in the later two groups were significantly higher than that of the former one(P<0.01), while there was no significant diference between the later two groups(P>0.05). 3. there is no case that misoprostol was completely dissolved in group one.there is no significant difference between the later two groups. And the amount of left misoprostol was little. 4.the amount of vaginal bleeding and side effects were no significant diffrence among them.Conclusion:the dissolved misoprostol make it more easy to be absorbed throuth vaginal mucous membrane,and the efficacy of cervical dilatation is increased. However,the acetic acid does not improve the efficacy any more. 600μg misoprostol dissolved by sodium chloride administrated intravaginally is the best method of the cervical extension be-fore surgical abortion.