米非司酮配伍米索前列醇治疗过期流产的临床研究

目的　米非司酮配伍米索前列醇治疗过期流产疗效观察。方法　米非司酮组 2 8例 ,采用米非司酮2 0mg ,一次顿服 ,2 4h无宫缩者 ,米索 0 4mg后穹窿放置 ;对照组 2 4例 ,口服乙烯雌酚每日三次 ,每次 5mg ,连服 3日后 ,行宫腔内羊膜腔外注入 0 1%利凡诺 5 0mg后 2 4h后无宫缩行钳刮术 ,观察服药后组织物自然排出情况、出血量、组织物排出的时间等。结果　米非司酮组组织物自然排出者占 85 7% (2 4 / 2 8) ,而乙烯雌酚组无 1例自然排出者 ,两者有显著性差异 (P <0 0 5 ) ;米非司酮组不全流产 8例 ,行清宫术 ,手术顺利 ,无 1例行二次清宫 ;乙烯雌酚组手术操作难度较大 ,有 6例行二次清宫术 ;米非司酮组从服药至组织物排出平均需2 0 1h ,乙烯雌酚组均为服药 72h后钳刮 ;米非司酮组 1例出血大于 10 0ml,乙烯雌酚组有 9例出血大于 10 0ml,两者有显著性差异 (P <0 0 5 )。结论　米非司酮用于过期流产效果令人满意 ,米非司酮配伍米索前列醇用于过期流产优于乙烯雌酚配伍利凡诺羊膜腔外注射。

The Clinical Observation of Mifepristone to Missed Abortion

Objective To explore the effect of Mifepristone matched Misoprofil on missed abortion.Methods 200mg Mifepristone was taken orally one time in Mifepristone group,then placed Misoprofil 0 4mg in posterior fornix to patients whose uterine didn't contract in 24 hours,Diethylstilbestrol 5mg,three times per day,was taken successively 3 days.Uterine cavity was cleaned after 24 hours after injecting 0 1% etakridin 50mg exo-amniotic cavity in uterine cavity in contrast group.The constitution output,volume of blood,constitution output time,and et al were observed after drugs were taken.Results The constitutions of spontaneous output were 85 7(24/28)in Mifepristone group,whereas there was none in contrast group.There was significant difference between them( P <0 05).Successful operation for cleaning uterine cavity in 8 incomplete abortions had been done and no one had been reoperated it.Operations were very difficult and there were 6 reoperations in contrast group.Even time from of taking drugs to exclude constitution was 20 1 hours in Mifepristone group,but curettages in all,patients were done after 72 hours taking drugs in contrast group.Volume of blood of only one patient was more than 100ml in Mifepristone group,but it was more than 100ml in 9 patients in control group.Striking difference was seen between them( P <0 01).Conclusions The effect of Mifepristone on missed abortion was satisfactory,Mifepristone matched Misoprefil was superior to Diethylstilbestrol matched etakridin exo-amniotic cavity injection to missed abortion.