米非司酮联合米索前列醇配合清宫术终止8~12周妊娠的临床疗效[摘要]目的探讨米非司酮联合米索前列醇配合清宫术终止8～12周妊娠的临床疗效。方法选择2012年5月～2013年5月在河北省邢台市任县医院妇产科门诊接受终止妊娠手术240例患者，其均为宫内妊娠并停经8～12周，将患者随机分为观察者与对照组，每组各120例。观察组采用米非司酮联合米索前列醇配合清宫术终止妊娠，对照组采用人工流产手术，术前使用0.2%利多卡因局部浸润麻醉。观察两组患者手术成功率、手术时间、术中出血量、宫口扩张情况、患者痛苦程度及术后恶心、呕吐、发热、腹痛、出血、手麻等不良反应。结果观察组手术成功率为98.3%，与对照组患者人流手术成功率（99.2%）比较，差异无统计学意义（P>0.05），但观察组宫口扩张总有效率为98.3%，明显高于对照组（77.5%），差异有统计学意义（χ2=12.31，P<0.05）。观察组手术时间、术中出血量及疼痛程度分别为（4.80±0.86）min、（10.70±2.57）mL、（1.90±0.51），均明显低于对照组的（7.30±1.23）min、（16.60±4.32）mL、（2.38±0.67），差异有统计学意义（P<0.05）。两组患者均出现不同程度不良反应，但两组发生情况差异无统计学意义（P>0.05）。结论米非司酮联合米索前列醇配合清宫术终止8～12周妊娠可促进宫颈松驰，软化宫颈，创伤小，并能够缓解术中痛苦，减少术中出血量，是一种安全、有效、实用的流产方法，值得推广。[关键词]米非司酮；米索前列醇；清宫术；妊娠；人工流产[]R169.42[文献标识码]A[]1673-7210（2014）06（c）-0107-04ClinicaleffectofMifepristonecombinedMisoprostoltogetherwithcompletecurettageofuterinecavityinterminatingpregnancyof8-12weeksMA激ngDOUGuizhenDepartmentofObstetricsandGynecology,RenCountyHospitalofXingtaiCity,HebeiProvince,Xingtai055150,China[Abstract]ObjectiveTostudytheclinicaleffectofMifepristonecombinedMisoprostoltogetherwithcompletecurettageofuterinecavityinterminatingpregnancyof8to12weeks.Methods240patientsreceivingterminationofpregnancyoperationintheDepartmentofObstetricsandGynecologyout-patientofRenCountyHospitalofXingtaiCityfromMay2012toMay2013,whowereintrauterinepregnancyandgestationwith8-12weeks,wererandomlydividedintotheobservationgroupandthecontrolgroup,120casesineachgroup.TheobservationgroupwasgiventhetreatmentofMifepristonecombinedMisoprostoltogetherwithcompletecurettageofuterinecavity,andthepatientsofcontrolgroupwerewasgiventhetreatmentofabortionwith0.2%Lidocainelocalinfiltrationpreoperativeanesthesia.Operationsuccessrate,operationtime,intraoperativebleedingvolume,cervicaldilatation,painandpostoperativesideeffects,suchasnausea,vomiting,fever,abdominalpain,diarrhea,bleeding,numbnessinthehandwereobserved.ResultsThedifferencebetweentheobservationgroupoperationsuccessrate(98.3%)andthecontrolgrouppatientsinducedabortionoperationsuccessrate(99.2%)wasnotsignificant(P>0.05),butthedilatationofcervixtotalefficiencyintheobservationgroup(98.3%)wassignificantlyhigherthanthatinthecontrolgroup(77.5%),thedifferencewasstatisticallysignificant(χ2=12.31,P<0.05).Theoperationtime,theamountofbleedingandseverepainofobservationgroupwere(4.80±0.86)min,(10.70±2.57)mLand(1.90±0.51),whichweresignificantlylessthanthatofthecontrolgroup[(7.30±1.23)min,(16.60±4.32)mL,(2.38±0.67)],thereweresignificantdifferencesbetweenthetwogroups(P<0.05).Thepatientsoftwogroupshadadversereactionswithdifferentdegree,butthetwogroupshadnosignificantdifference(P>0.05).ConclusionMifepristonecombinedMisoprostoltogetherwithcompletecurettageofuterinecavityinterminatingpregnancyof8-12weekscanpromotecervicalrelaxation,makecervicalsoftening,reducetrauma,andcanrelievethedistr...