论文部分内容阅读
目的探索米非司酮合并米索前列醇(米索)终止10~16周妊娠最佳剂量及最佳给药途径。方法将来自上海24所医院的2007例孕10~16周要求药物终止妊娠的妇女,随机分成4种不同的治疗组。组Ⅰ:511例,米非司酮75mg每天1次,连服2天(总量150mg),第3天晨口服米索0.6mg,每3~4小时重复1次,最多3次;组Ⅱ:491例,米非司酮100mg每天1次,连服2天(总量200mg),米索用法同组Ⅰ;组Ⅲ:519例,米非司酮用法同组Ⅰ,第3天晨阴道内放置米索0.6mg,每12小时重复1次,最多3次;组Ⅳ:486例,米非司酮用法同组Ⅱ,米索用法同组Ⅲ。结果4组24小时内的流产成功率分别为88.6%、89.4%、90.9%和94.0%。组Ⅳ的成功率明显高于组Ⅰ和组Ⅱ。24小时内流产成功者米索的用量,阴道给药者比口服给药者明显减少(P<0.001),胃肠道副反应发生率也明显降低(P<0.05)。结论口服米非司酮200mg合并阴道放置米索,是较好的药物终止10~16周妊娠的方法,可作为一种常规方法推荐在临床应用。
Objective To explore the optimal dose of mifepristone combined with misoprostol (misoprostol) to terminate the pregnancy of 10 ~ 16 weeks and the optimal route of administration. Methods A total of 40 pregnancies from 10 pregnant women in Shanghai’s 24 hospitals were enrolled in this study. Pregnant women were randomly assigned to 4 different treatment groups. Group Ⅰ: 511 cases, mifepristone 75mg once daily for 2 days (total 150mg), on the 3rd day morning oral misoprostol 0.6mg, once every 3 to 4 hours, up to 3 times; group Ⅱ: 491 cases, mifepristone 100mg once daily, even for 2 days (total 200mg), the use of misoprostol group Ⅰ; group Ⅲ: 519 cases, mifepristone use the same group Ⅰ, the first 3 days Intravaginal placement of misoprostol 0.6mg, repeated once every 12 hours, up to 3 times; Group Ⅳ: 486 cases, mifepristone use the same group Ⅱ, misoprostol group Ⅲ. Results The success rates of abortion within 24 hours in 4 groups were 88.6%, 89.4%, 90.9% and 94.0% respectively. The success rate of group Ⅳ was significantly higher than that of group Ⅰ and group Ⅱ. The amount of misoprostol that was successfully aborted in 24 hours was significantly lower in vaginal administration than in oral administration (P <0.001). The incidence of gastrointestinal side effects was also significantly reduced (P <0.05). Conclusions Oral mifepristone 200mg combined with vaginal misoprostol is a good method for stopping the pregnancy of 10 ~ 16 weeks and can be recommended as a routine method for clinical application.