摘要:目的：观察米非司酮配伍经阴羊膜腔外注入利凡诺、阴道放米索前列醇终止10～15周妊娠的效果及安全性。方法：选择10～15周妊娠要求终止的妇女400例，随机分为观察组和对照组。两组均服米非司酮每次25mg，一天3次，总量150mg，妊娠物排出后常规清宫。观察组经阴置入12号尿管，注入利凡诺50mg+注射用水30ml，同时后穹窿放置米索前列醇600μg。对照组助手两指放入阴道内托起子宫，经腹羊膜腔穿刺注入利凡诺100mg。观察两组的引流产效果、副反应及并发症。结果：两组的流产成功率均为100%。观察组及对照组的注药至宫缩的时间分别为2.08±1.23h和25.28±8.12h (P<0.001)；宫缩至妊娠产物排出的时间分别为4.26±2.65h和10.84±6.65h (P<0.001)；注药至妊娠产物排出的时间分别为6.34±3.12h和36.12±19.08h (P<0.001)；产后2h阴道出血量观察组<100ml的195例、100～200ml的0例，对照组<100ml的187例、100～200ml的6例(P<0.05)。两组无1例发生软产道裂伤、子宫损伤，且用药后的副反应小，不需特殊处理。 结论：米非司酮联合经阴羊膜腔外注入利凡诺、阴道放米索前列醇用于终止10-15周妊娠引产成功率高、时间短、并发症少，是安全、有效的方法。

    关键词：米非司酮; 米索前列醇; 流产

    Clinical Trial of Mifepristone in Combination with Vaginal Medicine for Termination of 10～15 week's Gestation

    ZHANG Ying-zi, et al

    (The Affiliated Hospital of Taishan Medical College, Shandong Tai'an 271000, China)

    Abstract: Objective：To study the effect and safety of mifepristone in combination with extra-amniotic rivanol and vaginal misoprostol for termination of 10～15 week's gestation. Method: A randomized comparative study in 400 women requesting medical abortion at 10～15 week's gestation was conducted. All women were given 25mg mifepristone once each 8 hours for a total dose of 150mg and after fetal evacuation, the curettage was completed immediately. In the experimental group, a catheter number 12 was inserted in the cervix and an extra-amniotic 50mg rivanol was given.In the same time, 600 microgram misoprostol was given vaginally. In the control group, an assistant placed two fingers vaginally to support the uterine.A single 100mg intra-amniotic injection of rivanol was completed. The efficacy ,side effects and complications were observed. Results: The successful abortion rate was 100% in both groups. The induction to uterine contraction intervals for the experimental group and control group were 2.08±1.23 hours and 25.28±8.12 hours respectively (P<0.001) . The uterine contraction to uterine evacuation intervals were shorter in the experimental group than in the control group (4.26±2.65 hours vs 10.84±6.65 hours, P<0.001). The mean time from initiation of termination to uterine evacuation was less in the experimental group than in the control group (6.34±3.12 hours vs 36.12±19.08 hours). This was statistically significant (P<0.001). 195 women had blood loss of 2 hours after curettage <100 ml and 0 woman had blood loss 100~200 ml in the experimental group.187 women had blood loss of 2 hours after curettage <100 ml and 6 women had blood loss 100~200 ml in the control group. This was also statistically significant (P<0.05). There were no cervical tears and rupture of uterine in two groups. Side-effects were mild and no treatments were needed.Conclusion: Mifepristone in combination with extra-amniotic rivanol and vaginal misoprostol for termination of 10-15 week's gestation is safe and effective because a higher successful frequency of induction of labor, a shorter induction-abortion interval and less complications. ......