摘要
目的观察米非司酮配伍米索前列醇终止生化妊娠(无法证实官腔内或官腔外妊娠的阶段)的临床效果。方法对月经周期规律、停经≤49 d 的早孕期妇女,依据停经天数、血清人绒毛膜促性腺激素β亚单位(β-hCG)和阴道 B 超检查结果分组:生化妊娠(G_1)组、早期临床妊娠(G_2)组和临床妊娠(G_3)组,各500例。给予米非司酮口服,每次25 mg,每天2次,连用3 d,米索前列醇自口服首片米非司酮72 h 后,顿服600μg,之后留院观察6 h。定期随诊并每日记录观察日志,观察治疗结局并进行满意度自评。结果 (1)孕囊排出:G_1组妇女123例(24.6%,123/500)见孕囊排出,而G_2组、G_3组分别有62例(12.4%,62/500)和33例(6.6%,33/500)未见孕囊排出。(2)治疗失败:G_1～G_3组需手术干预者分别为1例(0.2%,1/500)、20例(4.0%,20/500)和79例(15.8%,79/500),收住院者分别为5例(1.0%,5/500)、4例(0.8%,4/500)和0。(3)阴道出血:G_1～G_3组服用米非司酮期间阴道出血者分别为272例(54.4%,272/500)、141(28.2%,141/500)和87例(17.4%,87/500),3组比较,差异有统计学意义(P<0.05);平均阴道出血时间,G_1组为(5.8±1.5)d,G_2组(9.0±2.9)d,G_3组(14.3±5.9)d,3组比较,差异有统计学意义(P<0.05)。(4)副作用:3组妇女恶心、呕吐、腹痛的发生率高,但程度均较轻;头晕、头痛和腹泻在3组中发生均较少。(5)月经恢复:G_1组有97.2%(486/500)的妇女、G_2组有90.4%(452/500)的妇女月经能如期复潮,G_3组有86.6%(433/500)的妇女月经也能如期复潮。(6)自评满意度:G_1组为99.8%(499/500)、G_2组97.0%(485/500)、G_3组为73.8%(369/500)。结论米非司酮配伍米索前列醇终止生化妊娠是安全、有效的方法,无需等待官腔内临床妊娠被确定后再处理;对终止早期临床妊娠也是较好的方法。
Objective To explore the efficacy and safety of terminating biochemical pregnancy （the stage in which intrauterine or ectopic pregnancy cannot be confirmed） with mifepristone and misoprostol. Methods Mifepristone （150 mg） combined with misoprostol （600 μg） 3 days later were given to 500 biochemical pregnancies （ G1 ）, 500 early clinical pregnancies （ G2 ） and 500 clinical pregnancies （ G3 ） which were classified according to amenorrhea days, serum human chorionic gonadotropin-beta subunit （ β- hCG） and vaginal B-ultrasonic examinations. All were observed for 6 hours after taking misoprostol and returned for assessment per week. Results Expulsion of conceptus was G1 123 （24.6% , 123/500）, G2 438 （87. 6%, 438/500） and G3 467 （93.4%, 467/500）. Failure rate was G1 6 （1.2%, 6/500）, G2 24 （4. 8%, 24/500） and G3 79 （15. 8%, 79/500） for ongoing pregnancies, hospitalizations for suspected ectopic pregnancies and surgical intervention for heavy or long-time bleeding. Bleeding cases during the administration of mifepristone were G1 272 （54. 4% , 272/500）, G2 141 （28.2% , 141/500） and G3 87 （ 17.4% , 87/500） ; the mean bleeding days were G1 （ 5.8 ± 1.5 ）, G2 （9.0 ± 2.9） and G3 （ 14.3 ± 5.9） days. Other side effects including abdominal pain, nausea, vomiting and diarrhea were low and light in each group, increasing with advancing gestational age. Menses recovery was 486 （97.2%, 486/500）, 452 （90. 4%, 452/500） and 433 （86. 6%, 433/500） for each group on scheduled time. Satisfaction was 499 （99. 8%, 499/500）, 485 （97.0%, 485/500） and 369 （73.8%, 369/500） respectively. Conclusion Mifepristone and misoprostol in combination is as safe, and effective for termination of biochemical pregnancies as ordinary medical abortion. It does not need to wait till ectopic pregnancy is excluded.
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2007年第8期542-545,共4页
Chinese Journal of Obstetrics and Gynecology
