负压吸宫术前口服和阴道放置米索前列醇及米非司酮对宫颈扩张作用的比较

目的:比较终止早期妊娠负压吸宫术前口服和阴道放置米非司酮及米索前列醇对宫颈的扩张作用,观察副反应、手术时间及术中出血量。方法:将停经6～8周要求手术终止妊娠的130名妇女随机分为4组,A组(口服米非司酮)34例、B组(阴道放置米非司酮)32例、C组(口服米索前列醇)36例、D组(阴道放置米索前列醇)28例。阴道用药组于用药后12h,口服组于用药后24h行负压吸宫术。记录观察对象的宫颈扩张度、用药后副反应及术中出血量和手术时间。结果:宫颈扩张程度,D组与其他各组相比,差异有显著性(P<0.05),其余各组之间差异无显著性;D组的手术时间较B组明显缩短(P<0.05);D组无一例出现胃肠道反应,与其他各组相比,差异有显著性(P<0.05),术前阴道出血发生率较其他各组高(P<0.01),下腹痛的发生率较A组、B组高(P<0.01)。结论:负压吸宫术前口服或阴道放置米索、米非司酮均可扩张宫颈,但阴道放置米索前列醇效果好,且胃肠道反应发生率低,更适合有早孕反应的妇女。

A randomized Comparison of Misoprostol and Mifepristone Taken Orally and Put into Vagina in Cervical Dilatation before Vacuum Extraction

Objective: To compare the effectiveness of misoprostol and mifepristone taken orally and put into vagina in cervical dilatation prior to vacuum aspiration termination of early pregnancy, and to observe side-effect, operation time and amount of blood. Methods: 130 women who asked for termination of pregnancy with a normal intrauterine pregnancy between 6 to 8 weeks' gestation were divided randomly into 4 groups. Group A (n=34) took 100mg mifepristone orally 24 hours ago at the beginning of operation; Group C(n=36) took 200μg misoprostol orally at the same time; Group B(n=32) and group D(n=28) were put into 100mg and 200μg mifepristone in vaginal 12 hours ago, respectively. Results: The degree of cervical dilatation in group D was obviously different from that in other groups(P<0.05), and there was no significant difference among groupA,B,C. The operation lasting time in group D was much less than one in group B(P<0.05). No women in group D showed gastrointestinal side effects, there was significant difference(P<0.05). There were more women in group D complained vaginal bleeding before suction comparing with females in other three groups (P<0.01). And more women complained abdominal pain comparing with ones in group A,B (P<0.01). Conclusion: 200μg Misopristol put into vagina was more effective than the other three ways. For those who experienced "morning sickness", it was better to apply vaginal misoprostol.