超小剂量米非司酮配伍米索前列醇在超早期妊娠终止中的应用价值探讨

目的评价超小剂量米非司酮配伍米索前列醇在超早期妊娠终止中的应用价值,探讨其临床适用性。方法选择2010年6月至2012年6月于中航工业西安医院就诊的超早期妊娠孕妇252例,采用随机数字表法将其分为超小剂量组132例和常规剂量组120例。常规剂量组口服米非司酮片每次25 mg,每日2次,共2 d,48 h后口服米索前列醇每次0.2 mg,每日3片,超小剂量组口服米非司酮每次25 mg,每日1次,共2 d,48 h后口服米索前列醇0.2 m。观察两组孕妇妊娠终止的成功情况,服药后阴道出血时间及分布情况和不良反应情况。结果两组孕妇均得到有效妊娠终止,其中超小剂量组孕妇妊娠终止的成功率达96.21%(127例),常规剂量组孕妇的妊娠终止成功率为96.67%(116例),两组比较差异无统计学意义(P>0.05);超小剂量组孕妇的阴道出血时间显著短于常规剂量组[(5.1±1.5)d vs(6.1±1.5)d](P<0.05),超小剂量组126例孕妇在7 d内停止出血(95.45%),而常规剂量组112例孕妇在7 d内停止出血(93.33%),差异无统计学意义(P>0.05);超小剂量组孕妇出现的不良反应发生率为18.18%(24例),而常规剂量组孕妇的不良反应发生率达30.00%(36例),两组比较差异有统计学意义(P<0.05)。结论超小剂量米非司酮配伍米索前列醇可以有效终止超早期妊娠,且不良反应显著小于常规剂量,适合临床推广应用。

The Application Value of Ultra Low-dose Mifepristone and Misoprostol to Terminate the Early Pregnancy

Objective To analyze the value of low-dose mifepristone and misoprostol to terminate the early pregnancy,and to explore its clinical applicability.Methods A total of 252 cases of pregnant women in early pregnancy were selected from China Aviation Industrial Xi＇an Hospital during Jun.2010 and Jun.2012.Using the method of random-number table,they were divided into ultra low-dose of mifepristone and misoprostol group of 132 cases and conventional-dose of mifepristone and misoprostol group of 120 cases.The successful cases of pregnancy termination,vaginal bleeding time and the distribution and adverse effects in the two groups were observed.Results Both groups of patients received effective treatment,and the success rate of the ultra low-dose of mifepristone and misoprostol group was 96.21% （127 cases）,while it was 96.67% （116 cases） of the conventional-dose of mifepristone and misoprostol group,the difference was not statistically significant（P 〉 0.05） ; vaginal bleeding time in the ultra low-dose of mifepristone and misoprostol group was shorter than the conventional-dose of mifepristone and misoprostol group[（5.1 ± 1.5） d vs （6.1 ± 1.5） d]（P 〈 0.05）,the rate of bleeding stop within 7 days in the ultra low-dose of mifepristone and misoprostol group was 95.45 %（126 cases）,while in the conventional-dose of mifepristone and misoprostol group was 93.33 % （112 cases）,the difference was not statistically significant（P 〉 0.05） ; the incidence of adverrse effects of the ultra low-dose of mifepristone and misoprostol group was 18.18% （24 cases）,while it was 30.00%（36 cases）in the conventional-dose of mifepristone and misoprostol group,the difference was statistically significant （P 〈 0.05）.Conclusion Uhra low doses of mifepristone and misoprostol to terminate early pregnancy is effective,while the adverse effects are significantly less than the conventional dose therapy,and is suitable for long-term clinical application.