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米非司酮与米索前列醇不同用法在重复无痛人流中的应用观察
作者:王玉楣  
单位:同济大学附属第一妇婴保健院
关键词:米非司酮  米索前列醇  多次重复人流  静脉麻醉 
分类号:R169.42
出版年·卷·期(页码):2014·42·第五期(532-535)
摘要:

目的 探讨米非司酮,米索前列醇不同用法在多次重复无痛人流中的应用,观察几种方式的应用对宫颈软化,促子宫收缩,减少术中出血量及减少术后宫颈粘连并发症及缩短术后阴道流血时间等方面的效果。 方法 回顾性分析普陀区妇婴保健院2011年~2012年多次重复无痛人流术者250例,同济大学附属第一妇婴保健院2012年多次重复无痛人流术者50例,其中A组100例术前晚20:00口服米非司酮100mg, B组100例术前2小时阴道后穹窿放置米索前列醇400ug,C组100例术前晚20:00口服米非司酮100mg术前2小时舌下含服米索前列醇400ug,观察3组在术前胃肠道不适发生率,术中宫颈软化程度、手术时间、术中出血量、麻醉效果,术后宫颈粘连发生率,术后阴道流血时间等方面的差异。 结果 A,B,C组在软化宫颈、麻醉效果、术后宫颈粘连发生率方面与比较差异无显著性(P>0.05),C组在术前胃肠道不适,手术时间,术中出血量方面与A、B组比较差异有显著性(P〈0.05),A组在术后阴道流血时间与B、C组比较差异有显著性(P〈0.05)。 结论 米非司酮配伍米索前列醇用于多次重复无痛人流术前,能有效减少术中出血量,缩短手术时间,提高麻醉用药安全性,减少术后宫颈损伤并发症,缩短术后阴道流血时间,值得推广应用到所有高危人流术中。

Objective To discuss the application of Mifepristone,and Misoprostol which used in many times and repeated painless surgical abortions ,observe the different using in effect of softening the cervical ,to promote the uterine contractions ,to reduce the intraoperative blood loss, to decrease of postoperative cervical adhesion and to shorten the time of bleeding after operation. Methods Three hundred cases of many times and repeated painless surgical abortions were divided into three groups:A group 100 cases used Mifepristone 100mg po at 8pm the day before operation, B group 100 cases used Misoprostol 400ug in vagine vault two hours before operation, C group 100 cases used Mifepristone 100mg po at 8pm the day before operation,and sublingual with Misoprostol 400ug two hours before operation. Observed the differences of the three methods in softening the cervical ,to promote the uterine contractions ,to reduce the intraoperative blood loss, observe anaesthesia effect and decrease of postoperative cervical adhesion and to shorten the time of bleeding after operation. Result Group A,B,C in softening the cervical , anaesthesia effect and decrease of postoperative cervical adhesion were no statistically significant(P>0.05), Group C in operation times,gastrointestinal discomfortable, intraoperative blood loss compared with groupA, B were statistically significant(P<0.05), Group A in bleeding after operation compared with groupB ,Cwere statistically significant (P<0.05). Conclusion To joint Mifepristone with Misoprostol used in many times and repeated painless surgical abortions, may reduce the intraoperative blood loss, reduce the operation times reduce the cervical lesions, increasing the safety of the anesthetic to shorten the time of bleeding after operation. This method is worthed to application and to promote to all surgical abortions which with high risks.

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