芬太尼联合米索前列醇用于人工流产镇痛效果观察

目的:探讨芬太尼联合米索前列醇用于无痛人流手术的效果。方法:将328例无阴道分娩史要求人工流产的早孕妇女随机分成3组:A组(芬太尼组)110例,静脉推注芬太尼针0.002mg/kg,注毕手术;B组(米索前列醇组)106例,术前3h阴道放置米索前列醇400μg;C组(芬太尼联合米索前列醇组)112例,术前3h阴道放置米索前列醇400μg。术时静推芬太尼,剂量同A组。观察各组镇痛效果、宫颈扩张程度、出血量、人流综合征及药物副反应。结果:C组镇痛效果及宫颈扩张程度均优于A组、B组(P<0.01),术中出血量及药物副反应无明显差异(P>0.05),无1例发生人流综合征。结论:芬太尼联合米索前列醇用于人工流产较单纯用药效果好。用药简单、安全,值得临床推广。     

米索前列醇用于无痛人工流产的临床观察

目的:观察米索前列醇用于无痛人工流产术的临床效果。方法:将米索前列醇在无痛人工流产术前、后舌下含化,并与无痛人工流产术、一般人工流产术对比。观察镇痛效果、宫颈松弛度、手术时间、术中出血量及人工流产综合反应发生率、不良反应等指标。结果:米索前列醇应用于无痛人工流产手术前后,镇痛率100%,宫颈松弛软化率高,缩短了手术时间,减少了术中出血量,有效地避免了人工流产综合反应的发生,不良反应轻微。结论:米索前列醇用于无痛人工流产,能充分改善宫颈松弛度,缩短手术时间,减少手术中的出血量。此法简单易行、效果好、副反应少。     

丙泊酚配伍米索前列醇用于人工流产镇痛效果观察

目的:探讨无痛人工流产术前应用米索前列醇对宫颈的扩张效果。方法:将330例自愿要求行无痛人工流产术终止妊娠的早孕健康妇女随机分为观察组(A组)和对照组(B组)。A组于手术前3h口服米索前列醇0.2～0.4mg,然后在丙泊酚静脉麻醉下行人工流产手术;B组直接在丙泊酚静脉麻醉下行人工流产手术,观察两组宫颈扩张、手术时间、术中出血量、术后阴道流血时间、用药量及用药后副作用。结果:两组手术麻醉效果无显著差异(P<0.05)。但A组宫颈松弛度明显好于B组,手术时间A组也较B组明显缩短,且手术易于操作,术中出血量、术后阴道流血时间均明显少于B组,丙泊酚用药量减少(P<0.01)。两组均无人工流产综合症及无一例呼吸抑制发生。结论:丙泊酚静脉麻醉下实施人工流产,术前3h口服米索前列醇0.2～0.4mg,有较好的宫颈扩张作用,可增强子宫收缩,手术易于操作,术中出血少,术后阴道流血时间短,丙泊酚用量减少,值得临床推广应用。     

米索前列醇联合笑气在人工流产中的应用

为了减少人工流产受术者的痛苦，本文就2002年6月-2003年6月在本院门诊要求行人工流产的320例早孕初孕妇，采用米索前列醇联合笑气镇痛，取得满意效果，现报道如下。     

间苯三酚联合米索前列醇用于人工流产50例临床分析

目的:探讨间苯三酚联合米索前列醇用于人工流产术中的临床疗效及其安全性。方法:150例早孕妇女分为观察组、对照组和空白对照组各50例,观察组术前使用间苯三酚联合米索前列醇;对照组术前单纯使用米索前列醇;空白对照组术前不用药,观察3组的临床效果。结果:观察组和对照组比较在缓解疼痛方面差异有统计学意义(P<0.05);在降低胃肠道反应及体动的发生方面差异有高度统计学意义(P<0.01);宫口扩张、术中出血等相比观察组和对照组差异无统计学意义(P>0.05),观察组与空白对照组比较,镇痛效果、宫口扩张情况、术中出血量、不良反应经统计学分析,差异均有统计学意义(P<0.05)。结论:间苯三酚联合米索前列醇用于人工流产镇痛效果好,不良反应少,安全,简单,费用低,适于推广。     

米索前列醇在人工流产术中扩张宫颈的临床观察

<正>为了探索米索前列醇(以下简称米索)在人工流产术中扩张宫颈的临床效果,我们对198例要求行人工流产的孕6～13周健康妇女给予口服米索行药物扩宫,观察结果如下.     

丙泊酚联合芬太尼、米索前列醇在人工流产中的临床观察

目的：观察丙泊酚联合芬太尼、米索前列醇在人工流产中的应用效果。方法：将100例早孕妇女随机分为观察组和对照组各50例,观察组用丙泊酚静脉麻醉联合芬太尼、阴道后穹窿放置米索前列醇,对照组仅用丙泊酚。观察人流术中两组的镇痛效果、宫口松弛度,手术时间、术中出血量及丙泊酚的用量、不良反应及并发症。结果：丙泊酚联合芬太尼、米索前列醇用于人工流产镇痛有效率100%,宫颈软化率高,手术时间短,丙泊酚用量少,术中及术后出血少。结论：丙泊酚联合芬太尼、米索前列醇用于人工流产无痛效果肯定,不良反应少。     

米索前列醇在早期人工流产术中的应用

本文前瞻性地于人流术前口服米索前列醇作药物扩宫共５１例，与对照组５０例结果相对照。确诊早孕后口服米索前列醇２００μｇ，每日４次，共２天，服完末次药后１～３小时作吸宫人流术，研究组人流时宫颈变软，松弛可入６～７．５号宫颈扩张器者共４３例，总有效率为８４．３１％，对照组占３８％，Ｘ＾２检验Ｐ〈０．０１，差异非常显著，结果认为口服米索前列醇，可使宫颈变软，宫口松弛，是一种简便，安全，有效的药物扩宫法。     

米非司酮配伍米索前列醇用于人工流产术前的效果分析

目的评价米非司酮配伍米索前列醇用于早孕8～12周人工流产术前对宫颈的松弛效果。方法将要求无痛人工流产的健康早孕妇女分为两组，试验组术前应用米非司酮150mg及米索前列醇400μLg，然后在异丙酚静脉麻醉下行人工流产手术；对照组直接行异丙酚静脉麻醉下人工流产手术，对两组进行多项指标对比分析。结果试验组宫颈松弛度明显好于对照组，手术时间也较对照组明显缩短，且手术易于操作，术中出血少。两组均无人工流产综合征发生。结论米非司酮配伍米索前列醇用于无痛人工流产术前，有较好的宫颈松弛作用，手术易于操作，术中出血少，值得临床应用。     

斯帕丰联合米索前列醇用于人工流产镇痛的临床观察

人工流产是避孕失败导致意外妊娠的常用补救措施之一。目前临床上除了少部分选择无痛流产术外,多数于术前应用镇痛或扩张宫颈的药物以减轻疼痛和减少人工流产并发症。2005年1月至10月,我们采用在人工流产术前应用斯帕丰(Phloroglucinol Injection,通用名:间苯三酚注射液)联合米     

氧化亚氮联合米索前列醇在基层医院人工流产术中的临床应用

目的 观察用氧化亚氮（笑气）吸入性镇痛加米索前列醇做术前预处理对人工流产术的疗效。方法 将同期门诊924例早孕初产妇要求人工流产术而无手术禁忌证者随机分为两组，一组为氧化亚氮吸入组，另一组为宫旁利多卡因注射组，分别观察镇痛效果、综合反应程度及出血情况。结果 两组镇痛效果及出血量比较差异有非常显著性（P〈0．01），人工流产综合征出现程度有统计学意义。结论 氧化亚氮吸入镇痛加米索前列醇软化宫颈术前预处理用于人工流产术镇痛效果好，综合反应少，适合基层医院开展手术的需要。     

氧化亚氮并用米索前列醇镇痛在人工流产术中的应用

目的　探讨氧化亚氮与米索前列醇并用镇痛在人工流产术中的临床应用价值。方法　将 4 4 0例未产早孕妇女 ,随机分为笑气组、米索组、联合组、对照组 ,观察各组术中镇痛效果、宫颈扩张程度、手术时间、术中及术后出血量、人工流产不良反应发生率。结果　联合组及笑气组镇痛效果显著 ,联合组效果最佳 ,四组间两两比较差异显著 (P <0 0 5 )。联合组无痛人工流产率及 6号宫颈扩张器通过率最高 ,手术时间最短 ,与其他各组比差别均有显著性 (P <0 0 5 ) ,人工流产不良反应发生率最低。结论　氧化亚氮用于人工流产有较好的镇痛作用 ,加用米索前列醇镇痛效果更为理想     

Spontaneous abortion: a randomized, controlled trial comparing surgical evacuation with conservative management using misoprostol

Objective: To compare the efficacy of surgical evacuation of the uterus with medical evacuation using misoprostol in cases of spontaneous abortion.

Design: A prospective, randomized, controlled trial.

Setting: A university teaching hospital.

Patient(s): Six hundred thirty-five women who aborted spontaneously and who consented to pretreatment randomization.

Intervention(s): Routine surgical evacuation or medical evacuation of the uterus using misoprostol.

Main Outcome Measure(s): Immediate, short-term (2–3 weeks), and medium-term (6 months) medical complications.

Result(s): There was a significantly lower incidence of immediate and short-term complications in the group treated with misoprostol compared with the surgically treated group. There were also fewer major complications in the 6 months after treatment in the medically treated group. Approximately 50% of the medically treated group subsequently required surgical evacuation, and these subjects required significantly more analgesia.

Conclusion(s): Treatment with misoprostol can reduce the demand for surgical evacuation in cases of spontaneous abortion, and its use is associated with fewer medical complications.     

米索前列醇用于人工流产术前宫颈扩张给药时间的观察

目的　探讨口服米索前列醇用于人工流产术前宫颈软化扩张适宜的给药时间。方法　采用前瞻性对比研究 ,将 1 97例早孕妇女随机分为米索前列醇 4 0 0 μg术前 1h服、米索前列醇 4 0 0 μg术前 2h服用、米索前列醇 4 0 0 μg术前 1h服用配伍 1 %利多卡因宫颈 3点、 9点各注射 2ml以及不采用任何药物的A、B、C、D四组。观察并比较各组宫颈松弛程度、扩宫难易度、手术效果、疼痛程度、术前术后宫腔长度差、手术时出血量及人流综合征等参数。结果　A、B、C组在术前宫颈松弛度和扩宫难易度方面差异无显著性 (P >0 0 5 )。而A、B、C组与D组比较差异具有极显著性 (P =0 0 0 0 )。手术效果以及疼痛评分比较 :A组与B组比较差异无显著性 (P >0 0 5 ) ,A、B组与C组之间差异有显著性 (P =0 0 0 9、P =0 0 0 8) ;A、B、C组与D组比较差异有极显著性 (P =0 0 0 0 )。宫腔长度差及出血量在A、B、C、D组之间差异均无显著性 (P >0 0 5 )。A、B、C组均无人流综合征发生 ,D组 1例人流综合征。结论　人工流产术前口服米索前列醇 4 0 0 μg可以有效地软化扩张宫颈 ,减少受术者痛苦 ;术前 1h和 2h用药同样可以有效地软化扩张宫颈 ;口服米索前列醇配伍利多卡因宫颈局部麻醉镇痛效果更佳。     

Regimens of misoprostol with mifepristone for early medical abortion: a randomised trial

OBJECTIVE: To compare the efficacy, adverse effects and acceptability of the three most common misoprostol regimens used with mifepristone for medical abortion. DESIGN: Randomised nonblinded trial. SETTING: Three clinics associated with major research universities in Canada; two in major urban areas and one in a periurban area. POPULATION: Women of reproductive age. METHODS: Consenting women presenting for abortion services with gestations less than 56 days and who met inclusion criteria were given 200 mg mifepristone orally and then randomised into three misoprostol study groups: (group I) 400 micrograms of oral misoprostol, (group II) 600 micrograms of oral misoprostol, and (group III) 800 micrograms of vaginal misoprostol. Misoprostol was self-administered at home 24-48 hours following mifepristone, and participants were instructed to take a second similar misoprostol dose at 24 hours after the initial dose if bleeding was less than a normal menstrual period. MAIN OUTCOME MEASURES: Successful abortion without surgery was 94.1%, with no significant differences across the three study groups (94.7% in group I, 93.4% in group II, and 94.3% in group III; P= 0.975). RESULTS: Efficacy and adverse effects did not differ significantly across the three study groups. Pain increased significantly across the study and the gestational age groups and was associated with lower acceptability. CONCLUSIONS: There appears to be a range of safe and effective options for early medical abortion with mifepristone including a choice between oral and vaginal administration of misoprostol.     

米索前列醇阴道置入用于人工流产术的临床观察及护理对策

目的:探讨米索前列醇阴道穹窿置入在人工流产术中的临床意义及护理对策。方法:收集我院治疗的人工流产的未产妇200例,随机将其分为4组,术前、术中及术后均行积极的护理措施,组1、组2及组3患者在术前2小时分别放置米索前列醇200ug、400ug和600ug于阴道后穹窿,组4患者行常规人工流产手术。比较各组间宫颈软化程度、全身不良反应、疼痛程度评分、手术所耗时间、术中出血量情况。结果:①组1,组2及组3患者宫颈软化比例均显著高于组4(P<0.05)。组2和组3中宫颈充分软化的比例分别达到84%和90%,与组1(66%)相比明显增高,其差异均有统计学意义。在组2和组3间,其差异无统计学意义(P>0.05)。②组1和组4中均没有患者发生不良反应,而组2和组3中其发生率分别为2%和16%。组3中其比例均显著高于其他各组(P<0.05)。③与组4相比,其他各组手术耗时、疼痛程度评分及术中出血量均明显降低(P<0.05)。与组1比较,组2和组3手术耗时更短、疼痛程度评分更低、术中出血量更少(P<0.05)。而组2和组3之间,它们无显著性差异(P>0.05)。结论:人工流产术前阴道后穹窿放置米索前列醇不但效果明显,而且不良反应...     

First trimester abortion with mifepristone and three doses of sublingual misoprostol: a pilot study

OBJECTIVE: To evaluate the efficacy and safety of a medical abortion regimen with multiple doses of sublingual misoprostol 24 h after mifepristone. METHODS: The regimen was designed on the basis of pharmacokinetics of various routes of administration of misoprostol. Forty women < or = 8 weeks' gestation were given mifepristone 200 mg orally, followed 24 h later by three doses of misoprostol 200 microgm sublingually 6 h apart. They were followed up on day 3 and day 14 with transvaginal ultrasound. Pain and bleeding were assessed using a visual analogue scale and acceptability, by a questionnaire. RESULTS: Abortion outcome was assessed in terms of onset of pain and vaginal bleeding, time of expulsion of products and duration of vaginal bleeding. Seventy-five per cent of women experienced pain within 2 h after first dose of misoprostol. Bleeding began at a mean of 1.41 h after pain and expulsion at a mean of 6.1 h after first dose of misoprostol. Complete expulsion was confirmed in all women (100%) by ultrasound on day 14. The longest duration of bleeding was 12 days (mean 7.2 days) with 87.5% bleeding for < 10 days. Acceptability was 100% but 70% perceived pain to be moderate and 67.5% bleeding to be light or slightly more than menses. CONCLUSIONS: Medical abortion using three doses of sublingual misoprostol administered 24 h after mifepristone appears to be the most appropriate in terms of pharmacokinetics of the drugs. This pilot study associates the regimen with a short abortion process, which appears to be safe, highly efficacious and acceptable.     

Second trimester medical abortion with mifepristone followed by unlimited dosing of buccal misoprostol in Armenia

Objectives: The aim of the study was to assess the efficacy and acceptability of a regimen using mifepristone and buccal misoprostol with unlimited dosing for second trimester abortion in Armenia.

Methods: Women seeking to terminate 13–22 week pregnancies were enrolled in the study. Participants swallowed 200?mg mifepristone in the clinic and were instructed to return to the hospital for induction 24–48?h later. During induction, women were given 400?μg buccal misoprostol every 3?h until the fetus and placenta were expelled. The abortion was considered a success if complete uterine evacuation was achieved without oxytocin or surgery.

Results: A total of 120 women with a median gestational age of 18 weeks participated in the study. All women began misoprostol induction around 24?h after taking mifepristone. Complete uterine evacuation was achieved in 119 (99.2%) women. The median induction-to-abortion interval was 10.3?h (range 4–17.4) with a mean of 9.5?±?2.5?h. A median of four misoprostol doses (range 2–6) with a mean of 4?±?1 misoprostol doses were administered. The induction-to-abortion interval, number of misoprostol doses, pain score and analgesia use increased as gestational age advanced. Acceptability of the method was high among both patients and providers.

Conclusion: The medical abortion regimen of 200?mg mifepristone followed 24?h later by induction with 400?μg buccal misoprostol administered every 3?h, with no limit on the number of doses used for the termination of pregnancies of 13–22 weeks’ gestation is an effective and acceptable option for women.