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目的 :比较低剂量米索前列醇阴道用药配伍口服用药米非司酮中期妊娠引产的临床效果 ,寻求较为合理的给药途径和用药剂量。 方法 :1 1 6例引产的中期妊娠孕妇分为阴道组 ( 60例 )和口服组 ( 56例 )。两组均经米非司酮 ( 1 50 mg)预治疗后 ,于第 3天 1 7时分别给予米索前列醇 2 0 0μg放入阴道后穹隆或口服 ,次晨流产未完成者同途径追加 2 0 0 μg,每隔 3～ 4h重复 1次。 结果 :阴道组和口服组的总引产成功率无显著差异 ( 98.33% ,96.48% ,P>0 .0 5) ,但是米索前列醇 1次用药的成功率两组有显著差异 ( 70 .0 0 % ,1 7.86% ,P<0 .0 1 )。平均用药次数分别为 1 .44次和 3次 ,平均用药量分别为 2 92 μg和 746μg( P<0 .0 1 )。随着孕龄增加 ,用药至流产的时间延长 ,相关系数 ( r) =0 .91 1 6。产后出血量、月经恢复的日期及副作用两组均无明显差异。 结论 :低剂量阴道用米索前列醇配伍米非司酮用于中期妊娠引产较口服用药具有效果好、安全、剂量小、用药次数少的优点 ,是较为理想的用药途径。
OBJECTIVE: To compare the clinical efficacy of low-dose misoprostol vaginal drug with oral administration of mifepristone in the second trimester of pregnancy to seek a more reasonable route of administration and dosage. Methods: A total of 116 middle-term pregnant women who induced labor were divided into vaginal group (60 cases) and oral group (56 cases). After pretreatment with mifepristone (1 50 mg), both groups were given misoprostol 200 μg on the 3rd day after the vaginal fornix or orally, and those who failed the second morning miscarriage were added with the same way 200 μg, repeated every 3 ~ 4h. Results: There was no significant difference in the success rate of total induction of labor between the vaginal group and the oral group (98.33%, 96.48%, P> 0.05), but there was a significant difference between the two groups in the success rate of misoprostol (70.0 0%, 1 7.86%, P <0. 01). The average number of medication was 1.44 times and 3 times, the average dosage was 2 92 μg and 746μg (P <0.01). With the increase of gestational age, medication to abortion prolonged, the correlation coefficient (r) = 0.9116. Postpartum hemorrhage, menstruation recovery date and side effects were no significant difference between the two groups. Conclusion: The combination of misoprostol with mifepristone in low dose vaginal for mid-pregnancy induction of labor is more effective, safe, less dosage and fewer times of medication. It is an ideal route of administration.