甲氨蝶呤辅助早孕药物流产临床观察.docVIP

甲氨蝶呤辅助早孕药物流产临床观察 　　【摘 要】 目的:探讨甲氨蝶呤辅助米非司酮配伍米索前列醇终止早孕的临床效果。方法：将264例妊娠34~49天妇女随机分成观察组与对照组，对照组采用米非司酮配伍米索前列醇进行药物流产,观察组额外加用甲氨蝶呤辅助药物流产，对两组药物流产成功率、孕囊2h内的排出率、阴道出血持续时间、尿HCG 10天内转阴情况进行比较。结果：观察组药物流产成功率、孕囊2h内的排出率优于对照组，差异有高度统计学意义(P 　　【关键词】 甲氨蝶呤; 米非司酮; 米索前列醇; 药物流产 　　 　　Clinical observation of methotrexate auxiliary medical abortion of early pregnancy 　　LI Chunmei 　　Department of Obstetrics and Gynecology, 520 Hospital of PLA, Sichuan Mianyang 621000, China 　　【Abstract】 Objectives: To study clinical effects of methotrexate auxiliary mifepristone and misoprostol to terminate early pregnancy. Methods: 264 patients 34~49 days pregnant women were randomly divided into observation group and control group. The control group were treated with mifepristone and misoprostol for medical abortion, the observation group extra auxiliary medical abortion with methotrexate, the two group success rate of medical abortion, pregnancy sac discharge rate of 2 hours, the duration of vaginal bleeding, urinary HCG cloudy time were compared. Results: Success rate of medical abortion group, gestational sac within 2 hours of discharge rate of the observation group was better, the difference was highly statistically significant (P0.05). Conclusion: Single oral dose of 25mg methotrexate tablets assisted pregnancy abortion, can significantly improve the success rate of miscarriage, gestational sac shorter discharge time, to shorten the duration of vaginal bleeding, no significant increase in drug reaction. 　　【Key words】 Methotrexate； Mifepristone； Misoprostol； Medical abortion 　　 　　米非司酮配伍米索前列醇应用于终止≤49天的早期妊娠，是医疗机构十分常用的非手术措施终止早孕的一种方法，流产效果肯定、痛苦小、安全、副反应少或反应轻，但由于药物流产过程用时较长，开始用药至孕囊排出大都需要3~4天，且需要妇女到医院留观数小时，与手术流产相比相对费时又不方便，且存在药物流产不全、出血时间长等不足。当前的无痛人流让女性尤为担心的流产疼痛得到了有效解决，加上医疗市场化等原因，更可观的经济效益，方便省时，以及担忧药物流产的副作用等原因，使无痛人流得到了广泛推广，药物流产的优越性越来越受到忽视。因此，探寻有效的增强药物流产疗效、减少其副作用的方法对重新树立药物流产的优越性以及减少手术流产的并发症均极为重要。氨甲蝶呤是一种抗肿瘤药物，其治疗的安全性已通过大剂量治疗滋养细胞肿瘤得到证实，目前临床上用小剂量甲氨蝶呤治疗异位妊娠，显示效果肯定，且既无明显副作用，也无远期不良后果[1]。本研究采用口服25mg甲氨蝶呤片与米非司酮及米索前列醇并用进行