米非司酮在36例葡萄胎中的应用与分析

目的探讨葡萄胎清宫前、后服用米非司酮的临床效果。方法将2001年1月2006年1月住院确诊的葡萄胎患者72例随机分为两组，观察组：36例，每日空腹口服米非司酮片75mg（上午50mg，下午25mg），连服2d，共150mg，于第3d上午行清宫术，清宫后继续口服米非司酮片，每日50mg，连服3d，有高危因素者延长服药至6d。对照组：36例，只行清宫术。结果观察组和对照组宫颈充分软化及宫口扩张程度、术中人工流产综合反应发生率、清宫手术时间、术中出血量、二次清宫率均有非常显著差异（P〉0.01）。清宫术后均随访2年，两组恶变率有显著差异（P〉0.05）。结论葡萄胎清宫前、后服用米非司酮，可有效地软化、扩张宫颈，明显减少术中人工流产综合反应发生率，清宫手术时间明显缩短，术中出血量明显减少，二次清宫率及葡萄胎恶变率明显降低，是葡萄胎一种理想的药物辅助治疗方法。

The application and analysis of mifepristone in the 36 hydatidiform mole cases

Objective To investigate the clinical effects of mifepristone to the patients with hydatidiform mole before and after taking the removal of intrauterine cortents.Methods 72 cases of patients with hydatidifrom mole.Confirmed hospital from January 2001 to January 2006 were randomly divided into two groups.observer group:36 cases,fasting daily oral tablet 75 mg of mifepristone(50mg am,25mg pm) and even served two days a total of 150mg,on the third morning taking the removal of intrauterine contents,then continue to oral mifepristone,50mg daily,for 3 days,risk factors extend the medication to 6 days.Control group: 36 cases,only take the removal of intrauterine contents.Results In observation group and the control group,the extent of cervical fully softening and dilation,the comprehensive response rate of adortion,the operative time,blood loss,the second removal of intrauterine contents rates aresignificantly different(P<0.01).After the operation,the patients were followed up for two years,the rate of malignant chang was also significantly different(P<0.05).Conclusion Oral Mifepristone before and after taking the removal of intrauterine contents,which can effectively soften and dilate cervix,decrease significantly comprehensive response rate during abortion,the opertive time was signficantly shorter,bleeding was significantly reduced,secondary removal of intrauterine contents rate and the rate of melignant mole decreased.This is an ideal medication-assisted treatment to hydatidiform mole.