米非司酮治疗宫内残留的疗效与B超及病理检查的对照研究

目的：研究米非司酮治疗宫内残留的疗效与其B超及病理检查的关系。方法：160例宫内残留者均采用米非司酮治疗,按治疗前B超检查宫内残留物大小分为〈20mm组68例、20～30mm组54例、〉30mm组38例三组,记录三组排出物或刮出物大小及病理组织的结果,观察其治疗效果与B超及排出物病理检查的关系。结果：三组疗效分别为97.06%、85.19%、57.89%,两两比较有显著性差异（P〈0.05）;治疗前B超检查宫内残留物大小与排出物或刮出物大小符合率分别为100.00%、98.15%、97.06%,两两比较无显著性差异（P〉0.05）。病理结果：胚胎组织占多数为85%,余为陈旧性血块伴炎性细胞占15%,此两种类型疗效分别为80.88%、100.00%,两者之间比较有显著性差异（P〈0.05）。结论：胚胎残留及残留物的大小是影响米非司酮疗效的主要因素,B超是指导治疗的重要检查手段,对残留物直径〉30mm者,要密切观察临床症状,必要时及时行刮宫术,治疗的同时要抗感染治疗。

Control study on the residual effect of mifepristone treatment of intrauterine and the B-ultrasonography and pathological examination

Objective：To study the relationship between the efficacy of mifepristone on the treatment of intrauterine residue and B-ultrasonography or pathological detection.Methods：160 cases of patients with residual caught intrauterine were treated with mifepristone,were divided into three groups by B-ultrasonography before treatment of intrauterine residue size：68 cases 20 mm,54 cases was 20-30 mm,38 cases 30 mm,the discharges or scrapings size and pathology results of three groups were recorded,and the relationship between the efficacy of mifepristone and B-ultrasonography or pathological detection were observed.Results：The efficacy of the three groups were 97.06%,85.19%,57.89%,there were significant differences（P0.05）;the coincidence of the size of intrauterine residue used by B-ultrasonography and the size of discharges or scrapings were 100.00%,98.15%,97.06% respectively,there was no significant difference（P0.05）.Pathology results：embryonic tissue,the majority was 85%,more than the old blood clots associated with inflammatory cells（15%）,the efficacy of the two groups were 80.88%,100.00%,there was a significant difference between the two groups（P 0.05）.Conclusion：Residue of embryo and the size of the residue are the main factors affecting efficacy of mifepristone,B-ultrasonic guide is an important examination tool of the treatment,when the diameter of the residue 30 mm and the clinical symptoms should be closely observed,if necessary,curettage surgery and anti-infection treatment at the same time.