CAJ | 학술논문

目的：研究米非司酮对人工流产术后宫内残留的临床疗效及不同给药方案之间的疗效差异。方法选取2011年12月～2013年3月本院妇产科门诊中121例自愿流产患者，以阴道流血时间、血β-HCG值和B超检查为纳入标准，随机双盲分成3组。对照组予以益母草和抗菌药，研究组除此以外加服不同剂量的米非司酮（25mg和100mg）。通过B超、内分泌指标检测和临床观察，比较米非司酮对人流术后残留的疗效及不同给药方案之间的差异。结果米非司酮研究组和对照组的清宫发生率分别为33.33%和81.40%，具有明显的统计学差异（P＜0.01）。米非司酮给药2周后的宫内残留组织在2个研究组间的差异有统计学意义（P＜0.05），短时大剂量组的血β-HCG下降更为明显、宫内残留物缩小范围更大；给药2周后B超和血β-HCG值提示，研究组明显优于对照组，有统计学意义（P＜0.01），其中短时大剂量组疗效最突出；给药4周后的血β-HCG值在两研究组间差异无统计学意义（P＞0.05）。3组的阴道流血时间差异有统计学意义（P＜0.05），但大剂量组和小剂量组在愈合时间上差异无统计学意义（P＞0.05）。研究组的不良反应发生率差异无统计学意义（P＞0.05）。结论应用米非司酮治疗人工流产术后宫内残留可减少术后阴道流血时间，避免清宫发生，且短时大剂量给药更为有效。
목적：연구미비사동대인공유산술후궁내잔류적림상료효급불동급약방안지간적료효차이。방법선취2011년12월～2013년3월본원부산과문진중121례자원유산환자，이음도류혈시간、혈β-HCG치화B초검사위납입표준，수궤쌍맹분성3조。대조조여이익모초화항균약，연구조제차이외가복불동제량적미비사동（25mg화100mg）。통과B초、내분비지표검측화림상관찰，비교미비사동대인류술후잔류적료효급불동급약방안지간적차이。결과미비사동연구조화대조조적청궁발생솔분별위33.33%화81.40%，구유명현적통계학차이（P＜0.01）。미비사동급약2주후적궁내잔류조직재2개연구조간적차이유통계학의의（P＜0.05），단시대제량조적혈β-HCG하강경위명현、궁내잔류물축소범위경대；급약2주후B초화혈β-HCG치제시，연구조명현우우대조조，유통계학의의（P＜0.01），기중단시대제량조료효최돌출；급약4주후적혈β-HCG치재량연구조간차이무통계학의의（P＞0.05）。3조적음도류혈시간차이유통계학의의（P＜0.05），단대제량조화소제량조재유합시간상차이무통계학의의（P＞0.05）。연구조적불량반응발생솔차이무통계학의의（P＞0.05）。결론응용미비사동치료인공유산술후궁내잔류가감소술후음도류혈시간，피면청궁발생，차단시대제량급약경위유효。
Objective To evaluate the efficiency of mifepristone in treating intrauterine residual after induced abortion and compare the different ways of administrating mifepristone. Methods A total of 121 outpatients who accepted induced abortion at their own will were randomly divided into 3 groups with inclusion criteria of vaginal bleeding time,β-HCG in blood and type-B ultrasonic examination.Motherwart and antibiotics were given to controlled group. Except from the same administration as controlled group,the other two groups were arranged to take different dosages of mifepristone (25mg and 100mg).Via examination of type-B ultrasonic,endocrine indexes detection and clinical observation, the efficiency of mifepristone in treating intrauterine residual after induced abortion and different ways of administrating mifepristone were evaluated. Results Incidences of clear palace operation from the groups mifepristone was administrated to and the controlled group were respectively 33.33% and 81.40%,which indicated significant statistical difference(P < 0.01).After 2 weeds of applying mifepristone,significant statistical difference was discovered between two mifepristone groups(P < 0.05) and the group whose administration way was shorter time and larger dosage showed more efficient.In 2 weeks after administration, typ-B ultrasonic and blood β-HCG results validated that mifepristone groups were better compared to the controlled group with significant statistical difference(P < 0.01).The shot-time and large-dosage group were the outstanding as well. Opposite to comparison between 3 groups(P < 0.05),no significant statistical difference was found between the two mifepristone groups(P> 0.05).Furthermore,comparison between groups of large dosage and small dosage demonstrated no significant statistical difference(P > 0.05),the same as untoward effect(P > 0.05). Conclusion Application of mifepristone in the treatment of intrauterine residual after induced abortion is able to reduce vaginal bleeding time and prevent clear palace operation. Moreover,administration with short time and large dosage is more efficient.