单独应用米索前列醇紧急避孕临床效果观察

目的研究女性黄体早期单独应用米索前列醇进行紧急避孕的有效性、安全性和可接受性。方法采用前瞻性临床研究,选择符合接收标准、要求紧急避孕、并愿意参加本课题研究的221例育龄妇女作为研究对象。分米索前列醇组(78例)、米非司酮组(71例)、无避孕组(72例)三组,米索前列醇组空腹顿服米索前列醇200μg×2片,米非司酮组单次口服米非司酮25mg,预约预期下次月经后10d内随访。观察在黄体早期用药后的妊娠率、月经的变化和副作用。结果①米索前列醇组1例妊娠,失败率为1.3%,米非司酮组无妊娠,失败率为0;无避孕组12例妊娠,失败率为16.7%,米索前列醇组、米非司酮组与无避孕组间均有显著性差异。米非司酮组与米索前列醇组之间无显著性差异。②随访时米索前列醇组77例、米非司酮组71例及无避孕组60例月经已经来潮,米索前列醇组及米非司酮组开始出血时间早于无避孕组,经检验有显著性差异(p<0.05),而米索前列醇组与米非司酮组之间无差异(p>0.05);出血持续时间3组间无显著性差异,与正常月经经期基本一致。③应用两种药物均无不良后果,副作用轻,能自行缓解。结论黄体期单独应用米索前列醇紧急避孕也是有效、安全和可行的方法。

EFFICACY ASSESSMENT ON MISOPROSTOL FOR EMERGENT CONTRACEPTION

Objective To assess the efficacy,safety and feasibility on single misoprestol for emergent contraception in female early luteal phase. Methods 221 women meet the standard and voluntary were divided into three groups ：misoprestol group（78 cases） ,mifepristine group （71 cases） and no contraception group （72 cases）. In misoprestol group all objects fast draught took misoprestol 200 μg ×2; in mifeprestine group,took single dose of 25 mg of mifepristine. Precontract follow up within 10 days after next menstruation to observe the fail rate,changn of menstruation and adverse reaction. Results （1）In misoprestol group 1 case pregnant,contraception fail in 1.3% ; in mifepristine group no pregnancy,fail rate 0% ; in no contraception group 12 pregnancy,fail rate 16.7%. （2） In follow up,77 cases in misoprestol group,71 in mifepristine group and 60 in no contraception group had the return of menstruation, the former two groups started bleeding earlier than the last group with significant difference （p 〈 0.05 ）, and the difference between the former two groups is not significant （p 〈 0.05 ）, the duration of bleeding in three groups had no significant differenee, as long as normal menstruation. （3）There was no bad result in application of the two drugs, with slight adverse reaction which released automatically. Conclusion It is effective, safe and feasible to use misoprostol during early luteal phase for emergent contraception.