王　萍

福州市第七医院妇产科，福建福州350000

人工流产术前米索前列醇不同时间阴道给药的效果比较

王萍

福州市第七医院妇产科，福建福州350000

目的比较人工流产术前米索前列醇不同时间阴道给药的效果。方法将自愿要求行人工流产术的未生育的早孕妇女80例，随机分为四组，每组各20例。1 h组、2 h组和3 h组分别于人工流产术前1 h、2 h和3 h阴道放置400 μg米索前列醇，对照组术前不予米索前列醇，比较四组宫颈软化扩张程度、手术时间、术中出血量和人工流产综合反应发生情况。结果①1 h组、2 h组、3 h组的宫颈软化扩张总有效率分别为95%、100%、100%，明显高于对照组的35%（P＜0.05）；1 h组、2 h组和3 h组的宫颈软化扩张情况比较差异无统计学意义（P＞0.05）。②1 h组、2 h组和3 h组的手术时间、术中出血量及人工流产综合反应发生情况明显少于对照组（P＜0.05）；但上述指标在用药各组间比较差异无统计学意义（P＞0.05）。结论人工流产术前400 μg米索前列醇阴道用药可有效地促进宫颈软化扩张、缩短手术时间、减少术中出血量、降低人工流产综合反应发生率，人工流产术前1 h、2 h、3 h用药效果无明显差异。

人工流产；米索前列醇；阴道给药

［Abstract］Objective To compare the effect of transvaginal application of misoprostol before artificial abortion in different times.Methods A total of 80 early pregnant nullipara who volunteered to conduct artificial abortion were randomly allocated to four groups，each group had 20 cases.The patients who were allocated to group 1 h，group 2 h and group 3 h were treated with transvaginal application of 400 μg misoprostol before artificial abortion in one hour，two hours and three hours respectively，while the patients in control group with no misoprostol treatment.The results of the degree of cervical dilation，the operation time，the amount of blood loss during operation and the development of syndrome of artificial abortion were compared among the four groups.Results①The total effective rates of cervical dilation in group 1 h，group 2 h，group 3 h were 95%，100%，100%respectively，which were significantly higher than 35%of the control group（P＜0.05）；there was no significant difference among group 1 h，group 2 h and group 3 h in the degree of cervical dilation（P＞0.05）.②The operation time，the amount of blood loss during operation and the development of syndrome of artificial abortion in group 1 h，group 2 h，group 3 h were significant less than those of the control group（P＜0.05）；there was no significant difference among the groups which had misoprostol treatment in the above indexes（P＞0.05）.Conclusion Transvaginal application of 400 μg misoprostol before artificial abortion is effective in the cervical dilation，and can shorten operation time，reduce the amount of blood loss during operation，decrease the rate of syndrome of artificial abortion.The effect has no significant difference in one hour，two hours and three hours before artificial abortion.

［Key words］Artificial abortion；Misoprostol；Transvaginal application

人工流产术相对于药物流产具有手术成功率高、术后出血时间短及出血量较少等优势［1］，而作为避孕失败的主要补救措施，其手术扩张宫颈的过程往往给受术者带来一定程度的痛苦，尤其是宫颈条件差（如宫颈坚韧、年轻未生育等）的妇女因宫颈紧张度较高，扩张宫颈口的难度较大，使手术难度增加，手术时间延长，甚至可导致宫颈裂伤、子宫穿孔、人工流产综合反应等手术并发症的发生率增高［2］。……