米非司酮用量对孕早期稽留流产患者药流效果的影响

Effect of different of dosages mifepristone on medical abortion in patients with missed abortion in early pregnancy

目的探讨增加米非司酮用量对孕早期稽留流产患者药物流产效果的影响。方法选取本院2016年1月至2018年12月收治的305例孕早期稽留流产患者,随机分为对照组(n=133)、观察组1(n=79)和观察组2(n=93),分别给予米非司酮150 mg、200 mg、300 mg分次口服治疗,同时序贯给予米索前列醇600μg口服治疗,分别于3 d、1个月、3个月后复查,观察药物流产的效果。结果对照组、观察组1、观察组2用药后的妊娠物娩出时间、阴道出血持续时间依次降低,药流后3 d的完全流产率依次增高,差异具有统计学意义(P<0.05);观察组2药流后个1月的完全流产率高于对照组,差异具有统计学意义(P<0.05),观察组1药流后1个月的完全流产率与对照组比较差异无统计学意义;对照组、观察组1、观察组2药流后3个月的完全流产率比较差异无统计学意义;对照组、观察组1、观察组2用药后的不良反应发生率比较差异无统计学意义。结论适当增加米非司酮用量能加速妊娠物的排出、减少阴道出血时间、提高孕早期稽留流产患者药流后3 d的完全流产率,但对药流后1个月、3个月的完全流产率无明显影响。

Objective To explore the effect of increasing the dosage of mifepristone on drug abortion in patients with missed abortion on early pregnancy.Methods 305 cases of missed abortion patients admitted in our hospital from January 2016 to December 2018 were randomly divided into control group(n=133),observation group 1(n=79)and observation group 2(n=93).150 mg,200 mg and 300 mg mifepristone were given to the control group,observation group1 and observation group 2 respectively,and 600μg misoprostol were sequentially given to all the participants.The effects of the different dosages of drugs were observed on day 3,1 month and 3 months.Results The delivery time of pregnancy substance and the vaginal bleeding time successively decreased in control group,observation group 1 and observation group 2,while the complete abortion rate in day 3 significantly increased in three groups(P<0.05).After 1 month,the complete abortion rate of the observation group 2 was significantly higher than control group(P<0.05),while there was no significant difference between the complete abortion rates of control group and observation group 1.After 3 months,there was no significant difference among the complete abortion rate of three groups.The incidence of side effects of different dosages of drugs were almost the same with no significant difference.Conclusion Appropriate high dosage of mifepristone can accelerate the discharge of pregnancy products,reduce the time of vaginal bleeding,and increase the complete abortion rate of patients with missed abortion in the early pregnancy three days after drug abortion,but it has no significant effect on the complete abortion rate in the 1 and 3 month after drug intake.