摘要
目的 评估应用米非司酮联合米索前列醇催经的效果及副反应。 方法 在全国 8个研究中心共接收了 72 0名妇女 ,平均预期月经延迟 ( 4.9± 1 .7) d。接纳当天给予 1 50 mg米非司酮 ,3 6～ 48h后门诊阴道放置 40 0μg米索前列醇 ,并留院观察 1 h。嘱服药后 1 0 d内随诊。观察指标主要为妊娠、月经来潮。测定血清雌二醇 ( E2 )及孕酮 ( P) ,以分析月经延迟时的周期时相。 结果 在 72 0名妇女中失访 1人。在 71 9名妇女中 ,就诊时已经妊娠 492人 ,其中完全和不完全流产 46 7例 ( 95.0 % ) ;妊娠继续 2 4例 ( 4.9% ) ;异位妊娠 1例 ,作进一步处理。月经延迟 2 2 7名妇女 ,其中月经来潮 2 2 2例 ( 97.8% ) ;月经延迟>45d或停经者 5例 ( 2 .2 % )。服药后副反应中有恶心 9%、呕吐 3 .1 %。血清 E2 与 P显示 ,月经延迟者有 6 0 %仍处于卵泡期水平 ,仅 3 0 %处于黄体期 ;在妊娠组 ,6 0 %血清 P和E2 的水平相当于黄体期水平 ,说明已有极早期妊娠。 结论 米非司酮与米索前列醇联合应用是有效和安全的催经止孕方法 ,对解决妇女担忧非意愿妊娠有利 。
Objective: To evaluate the efficacy and side effects of using mifepristone in combination with misoprostol for menstrual regulation. Subjects and methods: A total of 720 subjects were recruited in 8 centers in China. Women recruited had a delay of (4.9±1.7) days in average after the expected onset of menstruation. The subject was given a single dose of 150 mg mifepristone, followed 36~48 hours later 400 μg misoprostol by vaginally at the clinic. Follow-up visit was arranged about 10 days after treatment. The outcome measures were return of menstruation or early pregnancy terminated. Serum levels of estradiol (E 2)and progesterone (P) levels were measured to evaluate the status of menstrual phase. Results: One case was lost to follow-up. Among 719 subjects 492 were pregnant at admission, pregnancy terminated (complete and incomplete) in 467 (95%), and pregnancy continued with further treatment in 24 (4.9%). There was one case of ectopic pregnancy. 227 women had delay of menstruation: menstruation was induced in 222 (97.8%), menstruation not induced >45 days or amenorrhea in 5 (2.2%) Over 9% of women had nausea and 5% had vomiting. Serum E 2 and P levels indicate that over 60% of the delayed menses were in the follicular phase and over 30% in the luteal phase levels. In the pregnant group E 2 and P levels were in the luteal phase levels, which may indicate very early stage of pregnancy. Conclusion: Mifepristone in combination with misoprostol is an effective and safe method for menstrual regulation, which will relieve many women from the anxiety of unwanted pregnancy and save them from seeking abortion in a later stage.
出处
《生殖医学杂志》
CAS
2003年第3期137-145,共9页
Journal of Reproductive Medicine
基金
洛氏基金会赞助项目"米非司酮降低非意愿妊娠和人流的合作研究与开发"
关键词
催经
米非司酮
米索前列醇
雌二醇
孕酮
Menstrual induction
Mifepristone
Misoprostol
Estradiol
Progesterone
