CAJ | 학술논문

目的：比较药物流产辅以清宫术与无痛人工流产术终止早期妊娠的临床疗效。方法将2013年6～10月泸州市人民医院妇产科收治的302例要求终止早孕者根据患者要求分为药物流产辅以清宫术组（A组）（151例）和无痛人工流产组（B组）（151例），A组给予晨空腹口服米非司酮片50 mg，2 h后进食，12 h 再服用1次，连服2 d，第3日晨空腹口服米索前列醇0．6 mg，在胚胎流出或宫口开大后于当日行清宫术；B 组给予丙泊酚静脉麻醉进行无痛人工流产。观察两组腹痛持续时间、阴道流血持续时间、完全流产率、二次清宫率以及其他并发症。结果 A组引起腹痛持续时间显著长于B组[（158．8±17．5） min比（7．1±1．6） min，P ＜0．01]，阴道流血持续时间显著短于 B 组[（93．7±13．3） h比（146．9±11．0） h，P＜0．01]。 A组和B组完全流产率分别为99．3％和96．7％，二次清宫率分别为0．7％和3．3％，差异均无统计学意义（ P＞0．05）。 A组其他并发症总发生率低于B组（5．3％比18．5％），差异有统计学意义（P＜0．01）。结论药物流产辅以清宫术在引起腹痛持续时间方面没有无痛人工流产术优越，但阴道流血持续时间较无痛人工流产术短，完全流产率和二次清宫率与无痛人工流产组相当，是一种相对安全和优越的终止早期妊娠的临床方法。
목적：비교약물유산보이청궁술여무통인공유산술종지조기임신적림상료효。방법장2013년6～10월로주시인민의원부산과수치적302례요구종지조잉자근거환자요구분위약물유산보이청궁술조（A조）（151례）화무통인공유산조（B조）（151례），A조급여신공복구복미비사동편50 mg，2 h후진식，12 h 재복용1차，련복2 d，제3일신공복구복미색전렬순0．6 mg，재배태류출혹궁구개대후우당일행청궁술；B 조급여병박분정맥마취진행무통인공유산。관찰량조복통지속시간、음도류혈지속시간、완전유산솔、이차청궁솔이급기타병발증。결과 A조인기복통지속시간현저장우B조[（158．8±17．5） min비（7．1±1．6） min，P ＜0．01]，음도류혈지속시간현저단우 B 조[（93．7±13．3） h비（146．9±11．0） h，P＜0．01]。 A조화B조완전유산솔분별위99．3％화96．7％，이차청궁솔분별위0．7％화3．3％，차이균무통계학의의（ P＞0．05）。 A조기타병발증총발생솔저우B조（5．3％비18．5％），차이유통계학의의（P＜0．01）。결론약물유산보이청궁술재인기복통지속시간방면몰유무통인공유산술우월，단음도류혈지속시간교무통인공유산술단，완전유산솔화이차청궁솔여무통인공유산조상당，시일충상대안전화우월적종지조기임신적림상방법。
Objective To compare the clinical efficacies of drug miscarriage combined with curettage and anodynia induced abortion in the termination of early pregnancy.Methods A total of 302 outpatient that required termination of early pregnancy in Luzhou People′s Hospital from Jun.to Oct.2013 were divided into two groups.According to the patients′requests, 151 cases received drug miscarriage combined with curettage were regarded as group A, and 151 cases received anodynia induced abortion were regarded as group B.Patients in group A orally took 50 mg of mifepristone in fasting morning,and had breakfast after 2 hours,took 50 mg of mifepristone after 12 hours again,took the same dosages on the second day,and orally took 0.6 mg of misoprostol on the morning of the third day,curettages were applied when cervix opened or embryonic outflow happened on the third day.Patients in group B received painless artificial abortion after propofol intravenous anesthesia.Duration of abdominal pain and vaginal bleeding,rates of complete abortion and second curettage,and incidences of other complications of the two groups were compared.Results Duration of abdominal pain of group A was longer than that of group B [(158.8 ±17.5) min vs (7.1 ± 1.6) min,P<0.01],and duration of vaginal bleeding of group A was shorter than that of group B [(93.7 ± 13.3) h vs (146.9 ±11.0) h,P <0.01].The rates of complete abortion of group A and group B were 99.3% and 96.7%,the rates of second curettage of group A and group B were 0.7%and 3.3%,respective-ly,and the differences were not statistically significant ( P>0 .05 ) .The general incidence of other compli-cations in group A was lower than that in group B(5.3% vs 18.5%,P<0.01).Conclusion The dura-tion of abdominal pain in drug miscarriage combined with curettage was not superior to anodynia induced abortion in the termination of early pregnancy,but duration of vaginal bleeding in drug miscarriage com-bined with curettage is much shorter than that in anodynia induced abortion .The rates of complete abortion and second curettage are similar between drug miscarriage combined with curettage and anodynia induced abortion.Therefore,drug miscarriage combined with curettage is a relatively safe and superior method for termination of early pregnancy.