国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2012, Vol. 31 ›› Issue (2): 89-92.

• 论著 • 上一篇    下一篇

负压吸宫术前宫颈准备的随机双盲临床研究

刘晓瑷,刘延,王海云,刘建华,乔勤勤,高燕   

  1. 200030上海交通大学医学院附属国际和平妇幼保健院（刘晓瑷）；上海交通大学医学院附属瑞金医院（刘延）；同济大学附属第一妇婴保健院（王海云）；上海交通大学医学院附属第九人民医院（刘建华）；上海交通大学医学院附属第一人民医院（乔勤勤）；复旦大学附属华东医院（高燕）
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2012-03-15 发布日期:2012-03-15
  • 通讯作者: 高燕

Cervical Priming Prior to Vacuum Aspiration，a Randomized and Double Blind Clinical Trial

LIU Xiao-ai，LIU Yan，WANG Hai-yun，LIU Jian-hua，QIAO Qin-qin，GAO Yan   

  1. International Peace Maternal and Child Health Hospital，Shanghai Jiaotong University，Shanghai 200030，China（LIU Xiao -ai）；Ruijin Hospital，Shanghai Jiaotong University，Shanghai 200025，China（LIU Yan）；Shanghai First Maternal and Infant Hospital Affiliated to Tongji University，Shanghai 200040，China（WANG Hai-yun）；Shanghai 9th People's Hospital，Shanghai Jiaotong University，Shanghai 200011，China（LIU Jian-hua）；Shanghai First People's Hospital，Shanghai Jiaotong University，Shanghai 200080，China（QIAO Qin -qin）；Huadong Hospital Affiliated to Fudan University，Shanghai 200040，China（GAO Yan）
  • Received:1900-01-01 Revised:1900-01-01 Published:2012-03-15 Online:2012-03-15
  • Contact: GAO Yan

PDF (PC)

7158

摘要： 目的：探讨妊娠早期负压吸宫术前使用米非司酮和米索前列醇促宫颈成熟的适宜时间与
剂量。方法：随机双盲安慰剂模拟对照多中心临床研究，纳入900例妊娠10周以内的初次妊娠（或仅有1
次早期流产史）妇女，观察比较米非司酮100 mg在术前12h服用（A组）或术前36h服用（B组）、米索前列醇
在术前3h服用0.6 mg（C组）或0.4 mg（D组）对宫颈软化的作用。结果：米非司酮的效果显示，宫颈扩张有效
率A组为65.73%，B组为77.10%（P越0.01）；宫颈扩张平均值A组为（6.21依1.08）mm，B组为（6.66依1.17）mm，2
组差异有统计学意义（P约0.01）；无论是否初次妊娠、是否静脉麻醉，均显示与总体情况一致的趋势。米索前
列醇的效果显示，宫颈扩张有效率C组为75.1%，D组为70.3%（P越0.261）；宫颈扩张平均值C组为（6.64依
1.15）mm，D组为（6.41依1.15）mm，2组差异有统计学意义（P越0.04）；初次妊娠对象显示与总体情况一致的
趋势。结论：米非司酮100 mg术前36h口服，或米索前列醇0.6 mg术前3h口服是较合适的妊娠早期负压吸
宫术前促宫颈软化的方法，米索前列醇更具有临床实用性。

关键词: 妊娠初期, 流产, 人工, 米索前列醇, 米非司酮, 子宫颈, 病例对照研究

Abstract: Objective：To evaluate the suitable time and dosage of mifepristone and misoprostol forthe cervical priming prior to vacuum aspiration. Methods：This is a randomized and double blind clinical trial. 900 cases of pregnant woman who wasprimi-gravid or had only once early abortion were randomly divided into four groups.100 mg of mifepristone were given at 12h（groupA）or 36h（groupB）pre-operation. 0.6 mg（groupC）or 0.4 mg（groupD）of misoprostol were given at 3h pre-operation. Effects of mifepristone and misoprostol on cervical primingwere compared. Results：The effective rates of cervical dilatation of mifepristone in group A and group B were 65.73% and 77.10%（P=0.01）, while the mean values of cervical dilatation were（6.21依1.08）mm and（6.66依1.17）mm, respectively（P约0.01）. The difference was insignificant when compared those results between people being primi-gravida or not, or compared people under anesthesia or not. The effective rates of cervical dilatation of misoprostol ingroup C and group D were 75.1% and 70.3%（P=0.261）, while the mean values of ervical dilatation were（6.64依1.15） mm and（6.41依1.15）mm, respectively（P=0.04）. Effect of misoprostol in primi-gravida women was identified with that of overall people. Conclusions：100 mg of mifepristone at 36h pre-operation or 0.6 mg of misoprostol at 3hpre-operation was suitable for the cervical priming prior to vacuum aspiration, and misoprostol was more practical.

Key words: Pregnancy, first trimester, Abortion, induced, Misoprostol, Mifepristone, Cervix uteri, Case-control studies