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【摘要】目的探讨米非司酮、米索前列醇联合戊酸雌二醇对稽留流产清宫术的临床疗效。

方法92例稽留流产患者随机分为两组各46例，对照组第1、2 d单纯口服戊酸雌二醇，第3 d行无痛清宫术，观察组第1、2 d给予米非司酮加戊酸雌二醇口服，第3 d晨起阴道塞米索前列醇，下午行无痛清宫术，比较两组效果。

结果观察组手术时间、术中失血量均较对照组明显减少（P<0.001）。观察组术中需宫颈扩张、二次清宫及人工流产综合征发生率均明显少于对照组，胚胎自然排出比例明显高于对照组（P<0.05）。

结论米非司酮、米索前列醇联合戊酸雌二醇能提高胚胎自然排出率，缩短清宫术手术时间，减少术中失血量，降低二次清宫率和并发症发生率。

【关键词】稽留流产；米非司酮；米索前列醇；戊酸雌二醇；清宫术

中图分类号：R719.3文献标识码：ADOI：10.3969/j.issn.10031383.2017.01.019

Analysis of curative effect of combination therapy for missed abortion curettage

[HJ1*2][HJ]

CHEN Lihua，HUANG Liqun，YE Huiyun，SU Xianfei，WU Ting

（Department of Gynecology， Peoples Hospital of Wuxuan，Wuxuan 545900，China）

[HJ2][HJ]

【Abstract】ObjectiveTo investigate clinical effects of mifepristone and misoprostol combined with estradiol valerate for missed abortion curettage.

MethodsA total of 92 patients with missed abortion were randomly divided into two groups，with 46 cases in each group.The patients of control group were given estradiol valerate orally on the first and second day，then they were given curettage operation on the third day.The patients of observation group were given mifepristone and estradiol valerate orally on the first and second day，and then they were given vaginal misoprostol on the third day after getting up in the morning，and received curettage operation in the afternoon.Clinical effects were compared between the two groups.

ResultsOperation time and blood loss of the observation group were significantly less than those of the control group（P<0.001）.Intraoperative cervical dilatation，need to second clearing uterus and abortion syndrome rate of the observation group were significantly less than those of the control group，and the natural embryo removal rate was higher than that of the control group （P<0.05）.

ConclusionMifepristone and misoprostol combined with estradiol valerate can increase natural embryo removal rate，shorten operation time and reduce blood loss，reduce second clearing uterus rate and incidence of complications.

【Key words】curettage operation；mifepristone；misoprostol；estradiol valerate；curettage

稽留流產为临床特殊的流产类型，指胎儿或胚胎死亡在宫腔内未自然排出，较长时间的滞留导致部分胚胎组织与子宫壁紧密粘连[1]。稽留流产增加剥离及刮宫难度，处理不当容易导致内膜损伤、影响再次受孕等，以往的治疗以清宫术或钳刮术为主，但术中操作难度大、对患者创伤大，且术中术后并发症较多，近年来药物配合清宫术在稽留流产治疗的临床报道越来越多，效果肯定[2]。本研究中我们应用米非司酮联合米索前列醇配合清宫术治疗稽留流产，取得令人满意的疗效，现报告如下。

1资料与方法

1.1临床资料