100例米非司酮配伍米索前列醇不同给药途径终止8～16周妊娠的临床观察

Clinical observation on termination of 8～6 weeks gestation with mifepristone and misoprostol by different routes of administration in 100 cases

目的观察米非司酮配伍米索前列醇不同给药途径终止8~16周妊娠的临床效果。方法选择2015年6月至2016年12月武汉市武东医院收治的100例孕8~16周要求流产的妇女,分为阴道给药组和口服给药组,每组各50例。两组均口服米非司酮100 mg,每天1次,连服2 d。阴道给药组第3 d米索前列醇600 ug阴道后穹窿上药;口服给药组第3 d米索前列醇400 ug口服。两组均可根据宫缩情况重复给药,但最多用药量不超过1 800 ug。观察两组流产效果。结果阴道给药组妊娠物排出时间明显短于口服给药组,药物的不良反应(恶心、呕吐、腹泻、荨麻疹等)明显少于口服给药组,差异有统计学意义(P<0.05);两组流产后阴道流血持续时间、阴道平均出血量、产道损伤率、完全流产率比较,差异无统计学意义(P>0.05)。结论米非司酮配伍米索前列醇终止孕8~16周的妊娠,方法简单、安全可靠;米索前列醇阴道给药在缩短妊娠物排出时间及减少药物不良反应上优于口服给药,值得临床推广应用。

Objective To observe the clinical efficacy of mifepristone combined with misoprostol by different routes of administration on termination of 8 to 16 weeks gestation. Methods 100 women with 8 - 16 weeks ＇gestation who volunteered to terminate pregnancy from June 2015 to December 2016 in Wuhan Wudong Hospital were selected,divided into vaginal administration and oral administration group,with 50 cases in each group. Both groups were given oral mifepristone 100 mg once daily for 2 days.And on the third day placed misoprostol 600 ug in the posterior fornix of the vagina in the vaginal administration group,while in the oral administration group,oral administration of 400 ug misoprostol. Both groups can be repeated administration according to the uterine contraction situation,but the maximum did not exceed 1 800 ug. The abortion effect of the two groups were observed. Results In the vaginal administration group,the time of pregnancy expelled from the uterus was significantly shorter than that in the oral administration group,meanwhile,adverse drug reactions（ nausea,vomiting,diarrhea,urticaria,etc.） were significantly less than those in the oral administration group. The differences were statistically significant（ P〈0. 05）. There were no significant differences between the two groups in the duration of vaginal bleeding,the average vaginal bleeding volume,the rate of birth canal injury,and the rate of complete abortion（ P〉0. 05）. Conclusion It has a good effect on the termination of 8 - 16 weeks gestation with the combination of mifepristone and misoprostol,the method is simple,safe and reliable; misoprostol vaginal administration is superior to oral administration in shortening the time of pregnancy expelled from the uterus and reducing adverse drug reactions,which is worthy of clinical application.