CAJ | 학술논문

目的：比较3种不同用药方案在无痛人工流产术前扩张宫颈的效果。方法回顾性分析2007~2011年在广西医科大学第一附属医院计划生育门诊要求行无痛人工流产术终止早期妊娠的338例初孕妇女的临床资料。根据不同用药方案将受术者分为3组，A组110例于人工流产术前3 h阴道放置米索前列醇200μg，B 组124例于术前15~20 h口服米非司酮50 mg联合术前3 h阴道放置米索前列醇200μg，C组104例于术前3 h阴道放置米索前列醇400μg。观察受术者宫口扩张程度、手术时间、术中出血量、不良反应等。结果 B、C 组宫颈扩张度优于 A 组，手术时间、术中出血量少于 A 组（ P<0.05）；C 组药物不良反应发生率高于 A、B组（P<0.05）。结论无痛人工流产术前15~20 h口服米非司酮50 mg联合手术前3 h阴道放置米索前列醇200μg 与术前3 h 阴道放置米索前列醇400μg 均有良好的扩张宫颈作用，口服小剂量米非司酮联合阴道放置米索前列醇在无痛人工流产术前应用更能减少药物的不良反应。
목적：비교3충불동용약방안재무통인공유산술전확장궁경적효과。방법회고성분석2007~2011년재엄서의과대학제일부속의원계화생육문진요구행무통인공유산술종지조기임신적338례초잉부녀적림상자료。근거불동용약방안장수술자분위3조，A조110례우인공유산술전3 h음도방치미색전렬순200μg，B 조124례우술전15~20 h구복미비사동50 mg연합술전3 h음도방치미색전렬순200μg，C조104례우술전3 h음도방치미색전렬순400μg。관찰수술자궁구확장정도、수술시간、술중출혈량、불량반응등。결과 B、C 조궁경확장도우우 A 조，수술시간、술중출혈량소우 A 조（ P<0.05）；C 조약물불량반응발생솔고우 A、B조（P<0.05）。결론무통인공유산술전15~20 h구복미비사동50 mg연합수술전3 h음도방치미색전렬순200μg 여술전3 h 음도방치미색전렬순400μg 균유량호적확장궁경작용，구복소제량미비사동연합음도방치미색전렬순재무통인공유산술전응용경능감소약물적불량반응。
Objective To eXplored effect of three methods of cervical dilatation before painless induced abortion. Methods Clinical data of 338 cases underWent painless induced abortion in early pregnancy in The First Affiliated Hospital of Guangxi Medical University from 2007 to 2011 Were retrospectively analyzed. Cases Were divided into three groups according to different therapeutic regimens. Cases in group A Were given 200 μg misoprostol by vaginal placement 3 hours before surgery,cases in group B Were given 50 mg mifepristone taKen orally 15 to 20 hours before surgery and 200 μg misoprostol by vaginal placement 3 hours before surgery, cases in group C Were given 400 μg misoprostol by vaginal placement 3 hours before surgery. The degree of cervical dilatation, operation blood loss,the duration of surgery and adverse effects Were observed. Results The degree of cervical dilatation of group B and group C Were superior to group A( P<0. 05). The duration of the surgery and the operation blood loss of group B and group C Were less than group A(P<0. 05). The adverse effect rate in group C Was higher than the other tWo groups(P<0. 05). Conclusion 50 mg mifepristone taKen orally 15 to 20 hours before surgery combined With 200μg misoprostol by vaginal placement 3 hours before surgery,and 400 μg misoprostol by vaginal placement 3 hours before surgery are both effective in cervical dilatation. LoW -dose mifepristone taKen orally combined With misoprostol by vaginal placement can reduce the adverse effects.