负压吸宫术前口服和阴道放置米索前列醇对宫颈扩张作用的随机比较研究

目的:比较在终止早期妊娠负压吸宫手术前口服和阴道放置米索前列醇对宫颈的扩张作用以及副反应。方法:将停经6～10周要求手术终止妊娠的100名妇女随机分为两组,分别口服或阴道放置400μg米索前列醇,用药后3～3.5小时行负压吸宫术。记录观察对象的宫颈扩张程度和用药后副反应以及术中出血量、手术所用时间。结果:两组对象宫颈扩张程度无明显差异(平均直径分别为6.96mm和7.02mm,P>0.05),口眼用药组恶心、呕吐发生率明显高于阴道用药组(P<0.05),阴道用药组腹痛的发生率大于口服用药组(分别为56％和44％),但差异无显著性(P>0.05)。其他副作用及术中出血量、手术所用时间等均无显著差异。结论:在终止早期妊娠的负压吸引术前口服或阴道放置米索前列醇400μg,均能有效扩张宫颈。口服用药方法简单、方便,可接受性好,但对于妊娠反应较明显的妇女,阴道用药更为可取。

A Randomized Comparison of Oral and Vaginal Misoprostol for Cervical Dilatation Before Vacuum Aspiration Termination of First-trimester Pregnancy

Objective:To compare the effectiveness of oral and vaginal misoprostol for cervical dilatation prior to vacuum aspiration termination of early pregnancy.Methods:One hundred women with a normal intrauterine pregnancy between 6 and 10 weeks 'gestation requested termination of pregnancy, were randomized to receive either oral or vaginal misoprostol 400 microgram 3 - 3. 5 hours before suction. Using Hegar's dilatator,degree of cervical dilatation before operration was measured. Other parameters assessed included pre-operative and intra-operative blood loss,the duration of operation and associated side effects. Results:There were no significant differences between the oral and vaginal treatment groups in the median cervical dilatation at vacuum aspiration(6. 96mm versus 7. 02mm,P> 0. 05 ). More women in the oral group suffered nausea and vomiting (P<0. 05). There were more women in the vaginal group complained abdominal pain than in the oral group, although this difference did not reach significance. No significant differences were noted in vaginal bleeding,intra-operative blood loss and other side effects between these two groups. Conclusion:Oral misoprostol 400 microgram and vaginal misoprostol 400 microgram were similarly effective for cervical dilatation in the early pregnancy interruption. Oral misoprostol offers convenience and higher acceptability. However, for those who experienced "morning sickness" ,it was better to apply vaginal administration.