米索前列醇3种给药途径用于人工流产术前扩宫效果的观察

目的:探讨无痛人工流产术前应用米索前列醇扩张宫颈的给药途径。方法:将300例自愿要求行无痛人工流产术终止妊娠的早孕妇女随机分为3组,每组100例,分别于术前3h舌下含服、口服、阴道后穹窿放置米索前列醇400μg,观察3组宫颈扩张程度、手术时间、术中出血量及用药后副作用。结果:3组宫颈扩张程度、手术时间、术中出血量差异无显著性意义(P>0.05),舌下含服组、阴道用药组恶心、呕吐、腹泻发生率明显低于口服用药组,差异有显著性意义(P<0.05),舌下含服组、口服用药组腹痛发生率低于阴道用药组,但差异无显著性意义(P>0.05)。3组术前出现阴道流血差异无显著性意义(P>0.05)。结论:无痛人工流产术前3h舌下含服、口服、阴道后穹窿放置米索前列醇400μg对于有效扩张宫颈疗效相似,舌下含服用药消化道副作用发生率低,阴道用药适合于妊娠反应重、胃肠功能差的受术者。

Comparative Study of Three Ways of Using Misoprostol for Cervial Dilation before Painless Artificial Abortion

Objective:To compare the best approach of using misoprostol for cervical dilation before painless artificial abortion. Methods: 300 women with early pregnancy who required termination of pregnancy by painless artificial abortion were randomly divided into three groups, and each group included 100 cases. Among three groups, two groups received 400μg misoprostol sublingually(sublingually administered group) and orally(orally administered group), respectively, and the other one group administered intravaginally(intravaginally administered group) 3 hours before operation. The following parameters were assessed included the degree of cervical dilation, the duration of operation, intra-operation blood loss and associated side effects. Results: There was no significant difference in the degree of cervical dilation, the duration of operation and intra-operation blood loss among three groups(P>0.05). The rates of suffering from nausea, vomiting and diarrhea in sublingually administered group and intravaginally administered group were significantly lower than those in orally administered group(P<0.05). There were no significant differences in the bleeding amount before operation among three groups(P>0.05). Conclusion: It shows the same effect for cervical dilation administered with 400μg misoprostol sublingually as orally or intravaginally 3 hours before painless artificial abortion. Administered with 400μg misoprostol sublingually appears lower gastro-intestinal symptoms. While intravaginal administration is fit for women who have severe pregnancy reaction or gastrointestinal disorders.