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[摘要] 目的 觀察不同剂量米索前列醇、米非司酮联合间苯三酚序贯疗法在终止妊娠中的应用价值。 方法 选取2011年1月～2013年1月河北省衡水市第二人民医院（以下简称“我院”）妇产科妊娠12～14周，且自愿性进行终止妊娠的孕妇110例为研究对象。根据干预方法的不同，将其分为A组（n = 55）和B组（n = 55），另选择2010年1～12月在我院终止妊娠者55例作为对照组。A组：米索前列醇（0.2 mg）、米非司酮联合间苯三酚；B组：米索前列醇（0.4 mg）、米非司酮联合间苯三酚；对照组：按常规将乳酸依沙吖啶注射液100 mg注射于患者的羊膜腔内。比较三组临产后疼痛程度、宫缩发动时间、总产程、产后阴道出血量、引产成功率及不良反应的发生情况。 结果 A组、B组患者临产后的疼痛程度与对照组比较，差异有统计学意义（P < 0.05）；A组、B组患者宫缩发动时间、总产程明显少于对照组（P < 0.05），A组与B组比较差异有统计学意义（P < 0.05）；A组、B组患者产后阴道出血量较对照组明显减少，引产成功率高于对照组（P < 0.05）；A组不良反应总发生率明显低于对照组及B组，差异均有统计学意义（P < 0.05）。 结论 米索前列醇、米非司酮联合间苯三酚序贯疗法能够显著降低患者的疼痛程度，加快患者宫颈扩张，有效缩短宫缩发动时间及终止妊娠时间，尤以米索前列醇0.2 mg为最佳，不良反应发生率低，值得推广。

[关键词] 米索前列醇；米非司酮；间苯三酚；序贯疗法；不同剂量；终止妊娠

[中图分类号] R719.3 [文献标识码] A [文章编号] 1673-7210（2016）02（b）-0111-04

Application value of different dosage of Misoprostol， Phloroglucinol and Mifepristone sequential therapy in the termination of pregnancy

CHEN Fengqun

Department of Gynecology and Obstetrics， the Second People's Hospital of Hengshui City， Hebei Province， Hengshui 053000， China

[Abstract] Objective To explore the application value of different dosage of Misoprostol， Phloroglucinol and Mifepristone in the termination of pregnancy. Methods 110 cases with 12 to 14 weeks of gestation， and undertake voluntary termination of labor resources from January 2011 to January 2013 in the Second People's Hospital of Gynecology and Obstetrics in Hengshui City （“our hospital” for short） were selected， and they were divided into group A （n = 55） and group B （n = 55）， according to the different method of intervention. 55 patients from January 2010 to December 2010 terminate pregnancies in our hospital were chosen as control group. Group A： Misoprostol （0.2 mg）， Mifepristone combined with Phloroglucinol； group B （n = 55）： Misoprostol （0.4 mg）， Mifepristone combined with Phloroglucinol； control group： conventional lactic acid in Sand Acridine Injection 100 mg of the amniotic cavity injection. The labor pain degree， contractions start time， total labor， postpartum vaginal haemorrhage amount， success rate of induced labor and the occurrence of adverse reactions between three groups were compared. Results Compared with the control group， the labor pain of patients in group A and group B was significantly reduced， the differences were statistically significant （P < 0.05）； contractions start time， total labor significantly in group A and group B were less than that of the control group （P < 0.05）， difference between group A and group B was statistically significant （P < 0.05）； compared with the control group， postpartum vaginal haemorrhage amount of patients in group A and group B were reduced obviously， and induced labor success rate of group A and group B was higher than that in the control group （P < 0.05）； incidence of total adverse reaction of group A was significantly lower than that in the control group and group B， the differences were statistically significant （P < 0.05）. Conclusion Misoprostol， Phloroglucinol and Mifepristone sequential therapy in the termination of pregnancy can significantly reduce the pain of patients， speed up the cervical dilation， effectively shorten the contractions start time and termination time， especially Misoprostol of 0.2 mg is the best， with lower incidence of adverse reactions， which is worthy of promotion.

[Key words] Misoprostol； Phloroglucinol； Mifepristone； Sequential therapy； Different dosage； Termination of pregnancy

随着社会的进步和发展，人们优生优育的意识逐渐增强，加之胎儿宫内诊断技术的提高，孕期要求终止妊娠的病例不断增多。因此，在临床上除了需要严格掌握引产适应证外，还必须选择一种安全、简便、有效的引产方法[1]。由于妊娠中期时，胎盘逐渐形成，相对面积较大，分泌大量雌、孕激素，而孕激素可以抑制子宫平滑肌收缩，利于胎儿宫内生长发育。另外，中期妊娠时羊水量也逐渐增多，子宫肌壁柔软、血流丰富、容易受损伤，因此在临床上选择安全、简便、有效的终止中期妊娠的方法是一个值得探讨的重要问题[2]。……