瘢痕子宫人工流产术前采用米非司酮联合米索前列醇预处理的临床疗效及安全性分析

Clinical efficacy and safety analysis of Mifepristone combined with misoprostol pretreatment before induced abortion of cicatricial uterus

目的探究瘢痕子宫人工流产术前预处理中应用米非司酮联合米索前列醇的临床疗效和安全性。方法选取64例行人工流产术的瘢痕子宫孕妇,依据双盲法将其分为探讨组与参照组,各32例。参照组不使用药物进行预处理,探讨组应用米非司酮与米索前列醇进行预处理。比较两组孕妇临床指标、宫颈软化效果、并发症发生情况及流产效果。结果探讨组术中出血量少于参照组,手术时间、术后阴道出血时间短于参照组,宫缩幅度大于参照组(P<0.05)。探讨组孕妇宫颈软化总有效率高于参照组(P<0.05)。探讨组孕妇并发症发生率低于参照组(P<0.05)。探讨组完全流产率为93.75%(30/32),高于参照组的71.88%(23/32),差异有统计学意义(χ2=5.3791,P=0.0204<0.05)。结论米非司酮联合米索前列醇在瘢痕子宫孕妇行人工流产术前进行预处理,不仅可以改善临床指标,还能够优化宫颈软化及流产效果,对降低并发症发生率也有促进作用。

Objective To explore the clinical efficacy and safety of mifepristone combined with misoprostol in preoperative preconditioning for induced abortion of cicatricial uterus.Methods 64 pregnant women with cicatricial uterus who underwent artificial abortion were selected and divided into the study group and the reference group according to the double-blind method,32 cases in each group.The control group was pretreated without drugs,and the discussion group was pretreated with mifepristone and misoprostol.The clinical indexes,cervical softening effect,complications and abortion effect were compared between the two groups.Results The intraoperative blood loss in the discussion group was less than that in the reference group,the operative time and postoperative vaginal bleeding time were shorter than that in the reference group,and the contraction amplitude was greater than that in the reference group(P<0.05).The total effective rate of cervical softening in the study group was higher than that in the control group(P<0.05).The complication rate of pregnant women in the study group was lower than that in the reference group(P<0.05).The total abortion rate in the study group was 93.75%(30/32),higher than that in the control group 71.88%(23/32),and the difference was statistically significant(χ2=5.3791,P=0.0204<0.05).Conclusion Pretreatment of mifepristone combined with misoprostol before induced abortion in pregnant women with scarred uterus can not only improve clinical indicators,but also optimize the effect of cervical softening and abortion,and reduce the incidence of complications.