三种用药方案在无痛人工流产术前宫颈扩张效果的比较

目的比较3种不同用药方案在无痛人工流产术前扩张宫颈的效果。方法回顾性分析2007~2011年在广西医科大学第一附属医院计划生育门诊要求行无痛人工流产术终止早期妊娠的338例初孕妇女的临床资料。根据不同用药方案将受术者分为3组,A组110例于人工流产术前3 h阴道放置米索前列醇200μg,B组124例于术前15~20 h口服米非司酮50 mg联合术前3 h阴道放置米索前列醇200μg,C组104例于术前3 h阴道放置米索前列醇400μg。观察受术者宫口扩张程度、手术时间、术中出血量、不良反应等。结果 B、C组宫颈扩张度优于A组,手术时间、术中出血量少于A组(P0.05);C组药物不良反应发生率高于A、B组(P0.05)。结论无痛人工流产术前15~20 h口服米非司酮50 mg联合手术前3 h阴道放置米索前列醇200μg与术前3 h阴道放置米索前列醇400μg均有良好的扩张宫颈作用,口服小剂量米非司酮联合阴道放置米索前列醇在无痛人工流产术前应用更能减少药物的不良反应。

Comparison of three methods of cervical dilatation before painless induced abortion

Objective To explored effect of three methods of cervical dilatation before painless induced abortion. Methods Clinical data of 338 cases underwent painless induced abortion in early pregnancy in The First Affiliated Hospital of Guangxi Medical University from 2007 to 2011 were retrospectively analyzed. Cases were divided into three groups according to different therapeutic regimens. Cases in group A were given 200 μg misoprostol by vaginal placement 3 hours before surgery,cases in group B were given50 mg mifepristone taken orally 15 to 20 hours before surgery and 200 μg misoprostol by vaginal placement 3 hours before surgery,cases in group C were given 400 μg misoprostol by vaginal placement 3 hours before surgery. The degree of cervical dilatation,operation blood loss,the duration of surgery and adverse effects were observed. Results The degree of cervical dilatation of group B and group C were superior to group A（ P〈0. 05）. The duration of the surgery and the operation blood loss of group B and group C were less than group A（ P〈0. 05）. The adverse effect rate in group C was higher than the other two groups（ P〈0. 05）. Conclusion 50 mg mifepristone taken orally 15 to 20 hours before surgery combined with 200μg misoprostol by vaginal placement 3 hours before surgery,and 400 μg misoprostol by vaginal placement 3 hours before surgery are both effective in cervical dilatation. Low- dose mifepristone taken orally combined with misoprostol by vaginal placement can reduce the adverse effects.