Objective To explore the lowest effective dosage of mifepristone combined with misoprostol in terminating ultra-early pregnancy.Methods All the cases of ultra-early pregnancy classified by amenorrhea days,β-hCG and vaginal B-ultrasonic were randomly divided into two groups.One hundred cases in G1 group (minimized dosage) were orally administered 25 mg mifepristone once a day for 2 days and combined with 200 μg misoprostol 48 hours later,while 150 mg mifepristone combined with 600 μg misoprostol 48 hours later were given to 100 cases in G2 group (normal dosage).All cases were observed for 6 hours after taking misoprostol and returned for assessment three days later.Results None missing.Expulsion of conceptus:G1 and G2 group were 22 (22.0％,22/100) and 25 (25.0％,25/100;P ＞ 0.05).Failure rate:cases with incomplete abortion were 1 (1.0％,1/100) and 2 (2.0％,2/100) in G1 and G2 group,hospitalization for suspected ectopic pregnancies both was 1 (1.0％).Bleeding:bleeding cases during the administration of mifepristone in G1 and G2 group were 71 (71.0％,71/100) and 78 (78.0％,78/100; P＞0.05); the mcan bleeding time were (5.3 ± 1.4) days and (6.0± 1.5) days (P ＜0.01).Other side effects:in G1 group,majority showed light nausea (7.0％,7/100) and light abdominal pain (20.0％,20/100).Menses recovery:99 (99.0％,99/100) for G1 group and 98 (98.0％,98/100) for G2 group to recovery on scheduled time.Satisfactions:both were 99 (99.0％,99/100).Except mean bleeding days and side-effects,the differences above showed no significance (P ＞ 0.05).Conclusion It is safe and effective treatment with the lowest dosages of mifepristone and misoprostol to terminate ultra-early pregnancies.%目的 观察超小剂量米非司酮配伍米索前列醇终止超早期妊娠(停经≤5周,血β-hCG水平高于正常、超声检查未见胎囊)的临床疗效.方法 选取2011年5月至2012年3月月经周期规律、停经≤5周的早孕期妇女,依停经天数、血β-hCG水平和B超检查确定为超早期妊娠后分组,超小剂量组100例,米非司酮50 mg两日法+48 h后口服米索前列醇200μg;常规剂量组100例,米非司酮150 mg两日法+48 h后米索前列醇600 μg顿服；均在米索前列醇服后留院观察6h.定期随诊并记录观察日志,观察治疗结局并进行满意度自评.结果 (1)孕囊排出:超小剂量组、常规剂量组妇女服药后可见孕囊排出分别为22例(22.0％,22/100)和25例(25.0％,25/100),两组比较,差异无统计学意义(P＞0.05).(2)治疗失败:超小剂量组、常规剂量组不全流产者分别为1例(1.0％,1/100)和2例(2.0％,2/100),可疑异位妊娠者均为1例(1.0％),两组分别比较,差异均无统计学意义(P＞0.05).(3)阴道出血:超小剂量组、常规剂量组妇女服用米非司酮期间开始阴道出血者分别为71例(71.0％,71/100)和78例(78.0％,78/100),两组比较,差异无统计学意义(P＞0.05)；平均出血天数为(5.3±1.4)、(6.0±1.5)d,两组比较,差异有统计学意义(P＜0.01).(4)副作用:超小剂量组头晕、头痛、恶心、呕吐、腹痛、腹泻的发生率分别为2.0％(2/100)、0、7.0％ (7/100)、1.0％ (1/100)、20.0％(20/100)、1.0％(1/100),均较常规剂量组低(P＜0.01),且以轻度恶心、轻度腹痛为主.(5)月经恢复情况:超小剂量组、常规剂量组月经如期恢复者分别为99例(99.0％,99/100)、98例(98.0％,98/100),推迟＞7d者分别为1例(1.0％,1/100)、2例(2.0％,2/100).(6)满意度:两组满意度均为99.0％(99/100).结论 超小剂量米非司酮配伍米索前列醇终止超早期妊娠是安全、有效的方法,疗效与常规剂量相当,副作用明显减轻.
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