范红梅

[摘要] 目的 探讨米非司酮联合米索前列醇终止10～14周剖宫产后瘢痕妊娠的临床观察。 方法 回顾性分析2014年6月～2016年5月于本院予米非司酮联合米索前列醇终止10～14周剖宫产后瘢痕妊娠孕妇30例为瘢痕妊娠组及10～14周非瘢痕终止妊娠孕妇30例为非瘢痕妊娠组。比较分析两组治疗效果、终止妊娠后阴道出血量及不良反应发生情况。结果 瘢痕妊娠组与非瘢痕妊娠组完全流产发生率、不完全流产发生率和流产失败发生率差异均无统计学意义（P>0.05）；瘢痕妊娠组与非瘢痕妊娠組终止妊娠后阴道出血流≤50mL发生率、50～100mL发生率、>100mL发生率及平均出血量差异均无统计学意义（P>0.05）；瘢痕妊娠组与非瘢痕妊娠组总不良发生率比较差异无统计学意义（P>0.05）。 结论 米非司酮联合米索前列醇终止10～14周剖宫产后瘢痕妊娠效果确切，完全流产成功率高，产后出血量少，不良反应低，是一种可靠安全的方法，值得临床进一步推广应用。

[关键词] 米非司酮；联合；米索前列醇；终止妊娠；瘢痕妊娠

[中图分类号] R719.31 [文献标识码] A [文章编号] 2095-0616（2017）08-103-03

[Abstract] Objective To observe the clinical observation of mifepristone combined misoprostol to terminate scar pregnancy for 10 to 14 weeks after cesarean section. Methods 30 patients who were admitted to our hospital from June 2014 to May 2016 and treated by mifepristone combined misoprostol to end scar pregnancy for 10 to 14 weeks after cesarean section were selected as the scar pregnancy group.30 patients who were treated to terminate non-scar pregnancy for 10 to 14 weeks were selected as the non-scar pregnancy group.Efficacy，vaginal bleeding volume after termination of pregnancy and occurrence of adverse reaction of two groups were compared and analyzed. Results Differences in the incidence of complete abortion，the incidence of incomplete abortion and the incidence of abortion failure of the scar pregnancy group and the non-scar pregnancy group had no statistical significance （P>0.05）.Differences in the incidences of vaginal bleeding volume of ≤50mL，50-100mL and >100mL after termination of pregnancy and mean blood loss of the scar pregnancy group and the non-scar pregnancy group had no statistical significance （P>0.05）.The total incidences of adverse reaction of the scar pregnancy group and the non-scar pregnancy group had no significant difference by comparison （P>0.05）. Conclusion Mifepristone combined misoprostol to terminate scar pregnancy for 10 to 14 weeks after cesarean section has exact efficacy，a high success rate of complete abortion，less postpartum bleeding volume and fewer adverse reactions，which is a reliable and safe method and is worthy of further promotion and application.

[Key words] Mifepristone；Combined；Misoprostol；Termination of pregnancy；Scar pregnancy

近年来，剖宫产率不断增多，而计划外瘢痕妊娠也不断增加[1]。剖宫产后子宫残留瘢痕、子宫血管和神经损伤、子宫与周围组织发生粘连，而改变了子宫解剖位置及形态[2]。过去，负压吸宫术是临床应用较为广泛的终止10～14周剖宫产后瘢痕妊娠的方法，此方法使得产后出血量、子宫穿孔及术后感染等各类并发症发生率较高，因此寻求一种更加安全、简便方法治疗此孕妇就尤为重要[3]。现今临床……