口服米非司酮和米索前列醇终止大月份妊娠临床观察

目的 :观察联合米非司酮和米索前列醇口服用药终止大月份妊娠的临床疗效以及用药方法、剂量、副作用和孕周与流产效果的关系等情况 ,以指导临床用药。方法 :选择 42例妊娠 10～ 2 6周身体健康的孕妇 ,无应用前列腺素的禁忌证 ,自愿服用药物终止流产。随机分成 2组。A组 2 2例 ,米非司酮早服 4片 /次 ,晚服 2片 /次 ,连用 2天 ;第 3天服用米索前列醇 ,早 6∶0 0、8∶0 0各服 3片。B组 :共 2 0例 ,米非司酮早服 4片 /次 ,晚服 2片 /次 ,连用 2天 ;第 3天服用米索前列醇 ,早6∶0 0顿服 6片。用药期间测量体温、心率、血压的变化 ;用药后观察阴道见红、宫缩开始时间、胚胎胎盘排出时间、阴道流血量以及有无恶心、呕吐、腹痛、腹泻等副作用。结果 :42例流产成功 41例 ,流产成功率达 97.6 % ,其中完全流产 37例 ,占90 .2 % ,不全流产 4例 ,占 9.8%。失败 1例和不全流产 4例均出现在A组。胚胎和胎盘排出时平均出血量为 (6 0± 40 .2 4)mL ,其中A组 (6 7.72± 45 .0 4)mL ,B组 (45 .45± 2 4.6 4)mL。排出胎儿身长平均 (10 .72± 4.45 )cm ,最大胎儿身长 16cm。副作用发生率 16 .7% (A组 9.1% ,B组 2 5 % )。所有副反应均较轻微而不必处理。结论 :联合应用米非司酮和米索前列醇是终止大月份妊娠的安全、经济、有

Clinical Observation of Mifepristone and Misoprostol in the Termination of Pregnancy

To investigate the effect of mifepristone combined with misoprostol in the terminetion of pregnancy. Method: 42 women with pregnancy of 10 to 26 weeks,who were voluntary to terminate the pregnancy and free of contraindication for prostaglandin,were ramdomly divided into two groups. Group A was orally administered mifepristone for two days,4 tablets in the morning and 2 tablets in the evening,followed by 3 tablets of misoprostol,twice at 6 am and 8 am on the third day. Group B was administered the same drugs in the same style except that 6 misoprostol tablets were taken once in the morning of the third day. Result: The total successful abortion rate was 97.6%(41/42),among them,37 cases were complete abortion (90.2%). One failed abortion and four incomplete abortion were in Group A. The total average bleeding amount was 60±40.24ml(67.72±45.04ml in Group A and 45.45±24.64ml in Group B). The average incidence of side effects was 16.7%(9.1% in Group A and 25% in Group B). All the side effects were mild and needed no special treatment. Conclusion: The combinding application of mifepristone and misoprostaol is safe,inexpensive and effective in the termination of pregnancy.