戊酸雌二醇联合抗早孕药物治疗稽留流产的临床应用

目的探讨戊酸雌二醇（补佳乐）联合米非司酮加米索前列醇在稽留流产中的应用效果。方法选取稽留流产患者90例,按治疗方法将其分为3组,每组30例：补佳乐组（A组）,补佳乐5 mg,3次.d-1,米非司酮25 mg,2次.d-1,均共服3 d,第4天加米索前列醇0.6 mg置阴道后穹隆;米索前列醇组（B组）,早晨8时给予阴道后穹隆放置米索前列醇0.6 mg;米非司酮加米索前列醇组（C组）,米非司酮25 mg,2次.d-1,共服3 d,第3天加用米索前列醇0.6 mg阴道后穹隆放置,均于用药结束后行清宫术。对3组的胚胎排出情况、宫颈扩张程度、术中并发症、术中出血量、手术时间、是否有残留等情况进行观察。结果术前全部或部分妊娠组织排出率比较,A、C组均高于B组（P〈0.05）,A、C组比较差异无统计学意义（P〉0.05）;C组的急诊清宫率均高于A、B组（P〈0.05）;A、C组宫颈扩张满意率高于B组（P〈0.05）,而手术时间、宫内残留和人工流产综合征发生率少于B组（均P〈0.05）,A、C组比较差异无统计学意义（P〉0.05）;A组术中出血量及术后出血持续时间少于B、C组（P〈0.05）。结论补佳乐联合米非司酮加米索前列醇对稽留流产患者术前进行预处理效果满意。

Clinical Application of Estradiol Valerate Combined with Anti-pregnancy Pills in Missed Abortion

Objective To explore the clinical efficacy of estradiol valerate combined with antipregnancy pills in the treatment of missed abortion. Methods Ninety patients with missed abortion were divided into three groups, with 30 patients in each group. In group A, 5 mg estradiol valerate （3 time per day）and 25 mg mifepristone （twice per days） were given for 3 days and 0.6 mg misoprostol was placed in the poste in the posterior vaginal rior vaginal fornix on the fourth day. In fornix in the morning （8：00）. In group group B, 0.6 mg misoprostol was placed C, 25 mg mifepristone （twice per days） was given for 3 days and 0.6 mg misoprostol was placed in the posterior vaginal fornix on the third day. The curettage was performed after medication treatment. The embryonic discharge, degree of cervical dilation, intraoperative complications, intraoperative blood loss, operative time and intrauterine residue were observed in the three groups. Results Compared with group B, rates of embryonic discharge and rates of patient satisfaction with cervical dilatation significantly increased and operative time and incidences of intrauterine residue and abortion syndrome markedly decreased in group A and group C （P〈0.05）, but there were no obvious differences between the two groups（P〉0.05）. Compared with group C, urgent curettage rates significantly decreased in group A and group B （P〈0.05）. Compared with group A, intraoperative blood loss and duration of postoperative bleeding remarkably increased in group B and group C（P〈0.05）.Conelusion The clinical efficacy of estradiol valerate combined with mifepristone and misoprostol is satisfactory in the preoperative pretreatment of missed abortion.