目的 觀察分析米索前列醇聯(lián)合米司非酮治療妊娠10～16 周稽留流產(chǎn)的療效及安全性。方法 選擇2010 年1 月—2013 年6 月在秦皇島經(jīng)濟(jì)技術(shù)開發(fā)區(qū)醫(yī)院婦產(chǎn)科治療的孕10～16 周稽留流產(chǎn)患者256 例和要求終止妊娠的孕10～16 周患者139 例,將稽留流產(chǎn)患者隨機(jī)分為A 組(給予米索前列醇)和B 組(給予米索前列醇和米司非酮),每組128 例;終止妊娠患者為C 組(給予米索前列醇),觀察3 組治療效果和不良反應(yīng)情況。結(jié)果 A、B、C 3 組完全流產(chǎn)率分別為64.06%(82/128)、87.50%(112/128)、66.19%(92/139),B 組與其他兩組差異有統(tǒng)計學(xué)意義(χ² 值＝21.450,P< 0.05);A 組與C 組比較,差異無統(tǒng)計學(xué)意義。B 組患者平均陰道出血量為(102.56±54.32)mL,明顯高于其他兩組的(80.24±48.97)mL 和(54.75±34.87)mL,差異有統(tǒng)計學(xué)意義(P< 0.05);A、B、C 3 組患者平均排胎時間分別為(12.78±4.89)、(13.59±5.87)、(13.47±4.21)h,差異無統(tǒng)計學(xué)意義;A、B、C 3 組患者不良反應(yīng)率分別為50.78%、54.69%和44.60%,差異無統(tǒng)計學(xué)意義,3 組患者均未經(jīng)特殊處理,癥狀自行緩解消失,無嚴(yán)重并發(fā)癥出現(xiàn)。結(jié)論 米索前列醇聯(lián)合米司非酮治療妊娠10～16 周稽留流產(chǎn)能提高完全流產(chǎn)率,排胎時間與終止妊娠患者相當(dāng),且未增加不良反應(yīng)的發(fā)生率。米索前列醇聯(lián)合米司非酮治療患者陰道出血量有所增多,但在正常范圍內(nèi)。

Objective To observe and analyze the efficacy and safety of misoprostol combined with mifepristone in the treatment of missed abortion during pregnancy of 10—16 weeks. Methods The missed abortion patients (256 cases) during pregnancy of 10—16 weeks of and patients (139 cases) with termination of pregnancy in 10—16 weeks in obstetrics and gynecology department from January 2010 to June 2013 in Hospital of Qinhuangdao Economic & Technological Development Zone were chosen, The missed abortion patients were randomly divided into group A (given misoprostol) and group B (given misoprostol combined with mifepristone), and patients with termination of pregnancy were in group C (given misoprostol). The effects and adverse reactions in three groups of misoprostol combined with mifepristone after the treatment were observed. Results The complete abortion rates in group A—C were 64.06% (82/128), 87.50% (112/128), and 66.19% (92/139), with statistically significant difference (χ² = 21.450, P < 0.05); Compared with group C, group A had no significant difference (χ² = 0.133, P>0. 0.05); The average amount of vaginal bleeding in group B was (102.56 ± 54.32) mL, significantly higher than those in the other two groups (80.24 ± 48.97 and 54.75 ± 34.87 mL), and the difference was statistically significant (P < 0.05); The average delivery time in three groups was 12.78 ± 4.89, 13.59 ± 5.87,and 13.47 ± 4.21 h, without significant difference (P>0. 0.05); The adverse reaction rates of three groups of patients were 50.78%, 54.69% and 44.60%, without significant difference (χ² = 2.772, P>0. 0.05), Three groups of patients did not receive special treatment, the symptoms alleviated spontaneously and disappeared, and no serious complications occurred. Conclusion The same dose of misoprostol combined with mifepristone in treatment of missed abortion of 10—16 weeks pregnancy and termination of pregnancy has the same curative effect. The appropriate increase of mifepristone dose can improve the treatment efficacy, but do not increase the adverse reaction occurrence, while the vaginal bleeding volume of patients will increase.