探讨米非司酮配伍米索前列醇治疗瘢痕子宫早孕的安全性及价值

To explore the safety and value of mifepristone combined with misoprostol in the treatment of scarred uterine early pregnancy

目的探讨对瘢痕子宫早孕患者应用米非司酮配伍米索前列醇治疗的安全性及临床价值。方法选取2017年8月至2018年8月期间河北省秦皇岛市妇幼保健院诊治的110例瘢痕子宫早孕患者作为研究对象。采用随机数字表法分为对照组(人工流产手术治疗)和观察组(米非司酮配伍米索前列醇药物治疗),每组各55例。对比治疗后患者的治疗疗效、孕囊排除时间、术中出血情况、宫颈损伤、宫腔残留率、术后腹痛发生率、不良反应及完全流产率等情况。结果经治疗后,观察组患者的临床总疗效为(96.36%)显著高于对照组患者的临床总疗效(72.73%);观察组患者的孕囊排除时间、术中出血情况、宫颈损伤等指标显著低于对照组患者的相关指标;观察组患者的宫腔残留发生率、术后腹痛发生率显著低于对照组患者的宫腔残留发生率、术后腹痛发生率;观察组患者的肠道反应、过敏反应、手术疼痛感发生率均小于对照组,且观察组完全流产率高于对照组,差异均具有统计学意义(均P<0.05)。结论对于瘢痕子宫早孕患者,采取米非司酮配伍米索前列醇治疗,可有效降低不良反应,且安全性较高,有较高临床应用价值。

Objective To investigate the safety and clinical value of mifepristone combined with misoprostol in the treatment of early pregnancy with scarred uterus. Methods 110 cases of early pregnancy with scar uterus admitted to our hospital from August 2017 to August 2018 were divided into control group(artificial abortion surgery) and observation group(mifepristone combined with misoprostol drug treatment), 55 cases in each group. After treatment, the curative effect, the time of excluding gestational sac, intraoperative bleeding, cervical injury, residual rate of uterine cavity, incidence of abdominal pain, adverse reactions and complete abortion rate were compared. Results After treatment, the total clinical efficacy of the observation group(96.36%) was significantly higher than that of the control group(72.73%);the pregnant sac exclusion time, intraoperative bleeding and cervical injury of the observation group were significantly lower than those of the control group;the incidence of residual uterine cavity and abdominal pain of the observation group were significantly lower than those of the control group. The incidence of residual uterine cavity and abdominal pain after operation was lower in the observation group than in the control group, and the rate of complete abortion in the observation group was higher than that in the control group, the difference was statistically significant(P<0.05). Conclusions Mifepristone combined with misoprostol can effectively reduce adverse reactions in patients with scarred uterine early pregnancy, and has high safety and clinical application value.