口服米非司酮预防早孕人流不全的临床研究

目的:探讨早孕人流负压吸引术后口服米非司酮对减少人流不全的作用。方法:3634例因早期妊娠要求行负压吸引术的健康妇女分为对照组1878例,常规负压吸宫;米非司酮组1756例,常规负压吸宫术后当天开始口服米非司酮25mg/×6d。结果:①人流术后再次行刮宫术共26例,发生率为0.72%。其中对照组19例(1.01%);米非司酮组7例(0.39%),组间有显著性差异(P<0.05)。②对照组复刮时刮出物病理检查,可见"绒毛、蜕膜和其他组织,如退变组织、增生期或分泌期内膜组织",但米非司酮组中刮出物未见残留的绒毛组织。③对26例人工不全流产作进一步分析,提示重复人流者有增加人流不全发生的趋势;普通人流者比术中应用麻醉者更易发生人流不全。结论:人流手术最好在孕6-8周进行,尽可能采用无痛人流,术后给予米非司酮口服可预防人流不全,尤其适用于伴有高危因素的人流手术妇女。

Clinical Study of Efficacy of Mifepristone for the Prevention of Incomplete Abortion with Early Pregnancy

Objective: To investigate the role of mifepristone in reducing the incomplete abortion after vacuum aspiration. Methods: A total of 3 634 women with clinically diagnosed first trimester pregnancy were randomized to 2 groups: control group (n=1 878) with routine vacuum aspiration and mifepristone group (n=1 756), which took oral mifepristone 25 mg/d×6 d. Results: (1) There were 26 patients out of 3 634 cases (0.72%) with incomplete abortion accepted curettage again, and 19 cases in control group (1.01%), 7 cases in mifepristone group (0.39%) (P<0.05). (2) Pathologic examination of tissues from uterus after curettage showed villus, deciduas and other tissues in control group, but no villus tissues in mifepristone group. (3) Further analysis for 26 cases with incomplete abortion showed that repeated abortion increased the occurrence of incomplete abortion and which occurred more easily in common abortion than in which anesthesia was performed. Conclusion: Mifepristone takes as a drug for prevention of incomplete abortion of first trimester, it has a role in reducing complications or side effects of induced abortion.