黎小紅　黎綺紅　阮翠梨

【摘要】 目的 比較稽留流產(chǎn)采用舌下含服、陰道給藥及口服米索前列醇終止妊娠的效果。方法 81例稽留流產(chǎn)患者， 按照隨機數(shù)字表法分為A組、B組和C組， 各27例。A采用舌下含服米索前列醇， B組采用陰道給予米索前列醇， C組采用口服米索前列醇。比較三組的臨床效果、子宮收縮時間、排胎時間、排胎2 h內出血量及不良反應發(fā)生情況。結果 A組有效率為92.59%， B組有效率為70.37%，?C組有效率為40.74%;A組有效率高于B組和C組， B組高于C組， 差異具有統(tǒng)計學意義（P<0.05）。A組患者的子宮收縮時間（28.14±4.58）min、排胎時間（9.59±2.67）h明顯短于B組患者的（35.73±5.82）min、（16.92±3.47）h和C組患者的（36.02±6.16）min、（18.15±3.61）h， 排胎2 h出血量（90.43±18.29）ml明顯少于B組患者的（120.27±23.17）ml和C組患者的（118.53±18.82）ml， 差異具有統(tǒng)計學意義（P<0.05）。A組患者腹痛發(fā)生率明顯高于B、C組患者， 差異有統(tǒng)計學意義（P<0.05）;三組患者陰道流血、胃腸道反應發(fā)生率比較差異無統(tǒng)計學意義（P>0.05）。結論 稽留流產(chǎn)采用舌下含服米索前列醇治療的臨床療效明顯優(yōu)于陰道及口服給藥， 但腹痛現(xiàn)象明顯， 臨床上應合理選擇治療方式。

【關鍵詞】 稽留流產(chǎn);舌下含服;陰道給藥;米索前列醇;終止妊娠

【Abstract】 Objective ? To compare the effect of sublingual administration， vaginal administration and oral administration of misoprostol for termination of pregnancy in missed abortion. Methods ? A total of 81 patients with missed abortion were divided by random number table into group A， B and C， with 27 cases in each group. Group A received sublingual administration of misoprostol， group B received vaginal administration of misoprostol， and group C received oral administration of misoprostol. Comparison were made on clinical effect， uterine contraction time， abortion time， bleeding volume within 2 h of abortion and occurrence of adverse reactions in three groups. Results ? Group A had effective rate as 92.59%， which was 70.37% in group B and 40.74% in group C. Group A had higher effective rate than group B and C， group B was higher than group C. Their difference was statistically significant （P<0.05）. Group A had obviously shorter uterine contraction time as （28.14±4.58） min，?abortion time as （9.59±2.67） h than （35.73±5.82） min， （16.92±3.47） h in group B， and （36.02±6.16） min， （18.15±3.61） h in group C， and obviously less bleeding volume within 2 h of abortion as （90.43±18.29） ml than （120.27±23.17） ml in group B and （118.53±18.82） ml in group C. Their difference was statistically significant （P<0.05）. Group A had obviously higher incidence of abdominal pain than group B and C， and the difference was statistically significant （P<0.05）. Three groups had no statistically significant in incidence of vaginal bleeding and gastrointestinal reactions （P>0.05）. Conclusion ? Sublingual administration of misoprostol shows obviously better clinical efficacy than viginal and oral administration， but the abdominal pain is obvious. So the treatment method should be rationally selectod in clinic.