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目的探讨采用不同剂量复方米非司酮配伍米索前列醇终止11～15周妊娠的临床效果。方法将232例11～15周妊娠要求终止的妇女随机分为观察组110例和对照组122例,观察组口服复方米非司酮30mg,q12h,连服2d,总量120mg;对照组口服复方米非司酮30mg/d,连服2d,总量60mg。2组均于首次服药48h口服米索前列醇200μg,继每4h舌下含服200μg,至妊娠物排出,每日总剂量不超过1800μg。2组均常规行清宫术。观察胚胎排出情况、阴道流血量及流血时间,月经恢复时间,用药后副反应。结果观察组与对照组比较,完全流产率(94.5%vs77.9%,P<0.01)及成功率(98.1%vs86.1%,P<0.01)明显提高,失败率明显降低(3.6%vs13.9%,P<0.01),胎儿排出时间[(6.92±2.8)vs(15.24±3.5)h,P<0.01]及出血时间[(7.25±3.41)vs(9.68±4.67)d,P<0.05]均缩短,出血量减少[(51.45±22.64)vs(69.68±36.45)ml,P<0.01];米索前列醇用量及月经恢复时间2组差异无统计学意义(P均>0.05)。结论增加复方米非司酮60mg终止11～15周妊娠,在完全流产率及成功率、胎儿排出时间、阴道出血量及时间等方面均优于常规剂量,不影响月经复潮,不加重副反应,安全、有效。
Objective To investigate the clinical effect of using different doses of compound mifepristone and misoprostol to terminate the pregnancy of 11 to 15 weeks. Methods A total of 232 women with 11 to 15 weeks’ gestation termination were randomly divided into observation group (n = 110) and control group (n = 122). The observation group received compound mifepristone 30 mg q12h for 2 days, Mifepristone 30mg / d, and even served 2d, the total 60mg. The two groups were given oral misoprostol 200μg 48h after the first dose, followed by sublingual sublingual 200μg every 4 hours until their pregnancy, and the total daily dose did not exceed 1800μg. 2 groups were routine curettage. Observed embryo discharge, vaginal bleeding and bleeding time, menstruation recovery time, side effects after treatment. Results The rate of complete abortion (94.5% vs77.9%, P <0.01) and the success rate (98.1% vs86.1%, P <0.01) were significantly higher in the observation group than in the control group, with a significant decrease in failure rate (3.6% vs13. (6.92 ± 2.8) vs (15.24 ± 3.5) h, P <0.01] and bleeding time [(7.25 ± 3.41) vs (9.68 ± 4.67) d, P <0.05) (51.45 ± 22.64 vs 69.68 ± 36.45 ml, P <0.01). There was no significant difference in the amount of misoprostol and menstruation recovery time between the two groups (all P> 0.05). Conclusions The increase of compound mifepristone 60mg terminates 11 to 15 weeks’ gestation, which is superior to the conventional dose in complete abortion rate and success rate, fetal discharge time, vaginal bleeding amount and time, etc. It does not affect the menstrual resuscitation and does not aggravate side effects ,Safe and effective.