米非司酮配伍米索前列醇联合早期刮宫在早孕人工流产术中的作用

Clinical effect of mifepristone and misoprostol combined with early uterine curettage in early pregnancy artificial abortion operation

目的探讨米非司酮配伍米索前列醇联合早期刮宫在早孕人工流产(人流)术中的效果。方法选取2014年1月至2015年1月该院妇科门诊收治的659例早孕患者作为研究对象,将其随机分为观察组(386例)和对照组(273例)。两组患者均给予米非司酮配伍米索前列醇方案作药物流产,观察组于服用米索前列醇3 h后常规行清宫术,对照组根据随诊情况决定是否进行清宫处理。另选取256例同期要求行无痛人流术的早孕患者作为无痛人流组。比较三组完全流产率、所需总费用、阴道出血量、出血时间、清宫术引起的疼痛情况。结果观察组完全流产率为100%,阴道出血量、出血时间均较对照组明显减少,差异均有统计学意义(P<0.05)。观察组和对照组所需总费用比较,差异无统计学意义(P>0.05);无痛人流组总费用高于观察组及对照组,差异均有统计学意义(P<0.05)。观察组轻度疼痛、重度疼痛发生率低于对照组,差异均有统计学意义(P<0.05)。结论米非司酮配伍米索前列醇联合早期清宫术能提高完全流产率,减少术中出血及出血时间,且所需总费用减少,适宜在农村地区推广。

Objective To investigate the effect of mifepristone and misoprostol combined with early uterine curettage in early pregnancy artificial abortion operation. Methods 659 early pregnant women in our hospital from January 2014 to January 2015 were selected as the research subjects and randomly divided into the observation group（386 cases） and the control group（273 cases ）. The two groups were given the medication abortion scheme of mifepristone and misoprostol. The observation group was per- formed the routine uterine curettage at 3 h after taking misoprostol, while whether conducting the uterine curettage in the control group was determined according to the follow up situation. Contemporaneous 256 early pregnant women requiring painless artifi- cial abortion were selected as the painless artificial abortion group. The rate of complete abortion,total cost,vaginal bleeding amount,bleeding time and pain situation caused by curettage operation were compared among 3 groups. Results The complete abortion rate in the observation group was 100%, the amount of vaginal bleeding and bleeding time were obviously reduced com- pared with the control group ,the differences were statistically significant （P〈0.05）. The needing total cost had no statistical differ- ence between the observation group and the control group （P〉0.05） ;the total cost in the painless artificial abortion group was high er than that in the observation group and the control group ,the difference was statistically significant （P〈0.05）. The occurrence rates of mild pain and severe pain in the observation group were lower than those in the control group with statistical difference （P〈 0.05 ）. Conclusion Mifepristone and misoprostol combined with early uterine curettage can increase the complete abortion rate,reduce intraoperative bleeding and bleeding time, moreover the needing cost is reduced, which is suitable for popularization in rural areas.