摘要
目的;比较米非司酮合并米索前列醇与利凡诺羊膜腔内注射终止16～24周妊娠的临床效果及各自的优缺点。方法:将来自上海市13所医院的829例孕16～24周要求终止妊娠的妇女,随机分成2种不同的治疗组。组Ⅰ(双米组):415例,米非司酮 100mg/qd连服两天(总量 200mg),第 3天晨阴道内放置米索前列醇 0.4mg,每 12小时重复 一次,最多3次;组Ⅱ(利凡诺组):414例,羊膜腔内注射利凡诺100mg,不加任何辅助方法,胎儿胎盘娩出后常规清宫。结果:两组流产成功率分别为91.6％和92.3％,两组间的差异有显著性意义(P>0.05);两组流产成功者用药至胎儿排出时间分别为57.69±7.85小时和46.92±10.06小时,两组间的差异有显著性意义(P<0.01);两组流产成功者产程分别为8.09±6.97小时和11.4±8.28小时,双米组产程时间明显短于利凡诺组,P>0.001;流产后阴道流血量和阴道流血时间两组间差异无显著性意义(P>0.05);双米组胃肠道反应和头痛、眩晕等副反应发生率高于利凡诺组(P<0.05),但无需处理。结论:口服米非司酮200mg合并阴道放置米索前列醇是较好的药物终止16～24周妊娠的方法,可以作为一种常规方法在有条件的医院中应用。
Objective: To determine the advantages and disadvantages of mifepristone followed by misoprostol com-pared with intra amniotic injection of Rivanol for termination of 16-24 weeks of gestation. Method: Eight hundred and twenty-nine women with 16-24 weeks gestation from 13 hospitals in Shanghai were randomizd to two groups. Four hundred and fifteen women in Group I took 100mg mifepristone once a day for two days with total dose of 200mg followed by 0.4mg misoprostol administered vaginally in the third morning, repeated every 12 hours for no more than 3 times. Four hundred and fourteen women in Group Ⅱ were used 100 mg Rivanol for intra-aminiotic in-jection without any other supplementary method. Routine curettage was performed after delivery of the fates and pla-centa. Result:The successful abortion rates of Group I and Group Ⅱ were 96.1% and 92.3% respectively with sig-nificant difference (P<0.05). The time between using medication and delivery of fetus among women with successful abortion in Group Ⅰ and Group Ⅱ was 57.69±7.85 hours and 46.92 ± 10.06 hours respectively with significant dif-ference(P<0.01). The time of delivery among women with successful abortion in GroupⅠand Group Ⅱ was 8.09±6.97 hours and 11.4±8.28 hours which was significantly shorter in women taking mifepristone and misoprostol. There was no significant difference in vaginal bleeding and the duration of bleeding after abortion in the two groups (P<0.05).The incidences of side effects of digestive tract, headache and dizziness were higher in women taking mifepristone and misoprostol than women using Rivanol(.P<0.05). However,no treatment was needed. Conclusion: Taking 200 mg mifepristone followed by vaginal misoprostol is a good method for medical abortion to 16-24 weeks of gestation which can be routinely used in hospitals with certain facilities.
出处
《中国计划生育学杂志》
2001年第6期348-352,共5页
Chinese Journal of Family Planning
基金
上海人口与计划生育委员会资助
