利凡诺羊膜腔注射与米索药物在中期引产中的疗效研究

摘要

Objective:To access the effectiveness and safety of intravaginal misoprostol following mifepristone administration to terminate 14-20weeks gestation.Methods: Eighty patients requesting legal termination of pregnancy at gestational between 14 to 20 weeks were from the Xuan Wu Hospital of capital University of medical of science between January 2012 and December 2012. They were divided randomly into two groups. Both 40 women (experimental group) and 40 women (control group) received 50mg of oral mifepristone every 12h for three times. Then, the experimental group was given 200μg misoprostol intravaginal at 7am on the third day and the control group received intra-amniotic injection of rivanol.Results: Comparing with intra-amniotic injection of rivanol, the combination of mifepristone and misoprostol intravaginally has higher success rate, lower tissue residue rate and curettage of uterus, shorter labor and less hemorrhage, the difference were statistically significant. As to the side effects, nausea, vomiting are statistically significant.Conclusion: It is a safe and effective method for mifepristone and vaginal misoprostol to termination of mid-pregnancy.%目的：研究探讨利凡诺羊膜腔注射与米非司酮配伍米索前列醇阴道放药用于孕中期妊娠引产的临床有效性和安全性。方法：选取孕周在14～20周自愿要求终止妊娠的80名孕妇，随机分为观察组和对照组，每组40例，两组均给予米非司酮150 mg分3次口服，间隔12 h。观察组第3日晨7点阴道内放置米索前列醇200μg；对照组使用利凡诺引产，比较两组从用药到胎儿排出的时间、出血量及引产并发症等情况。结果：两组孕妇在年龄、引产前孕周及孕次等相比无差异。两组孕妇从用药到胎儿排出的时间、分娩出血量方面比较，差异有统计学意义(t=16.03，t=-8.0， P＜0.05)。与利凡诺羊膜腔内注射相比，米非司酮配伍米索前列醇阴道上药引产成功率高，组织残留率和清宫率低，产程短，出血量亦较对照组少，差异均具有统计学意义。副反应方面，观察组恶心、呕吐发生率均较对照组高。结论：米非司酮联合米索前列醇阴道上药是终止中期妊娠的一种安全、有效方法。