目的 观察分析米索前列醇联合米司非酮治疗妊娠10～16 周稽留流产的疗效及安全性。方法 选择2010 年1 月—2013 年6 月在秦皇岛经济技术开发区医院妇产科治疗的孕10～16 周稽留流产患者256 例和要求终止妊娠的孕10～16 周患者139 例,将稽留流产患者随机分为A 组(给予米索前列醇)和B 组(给予米索前列醇和米司非酮),每组128 例;终止妊娠患者为C 组(给予米索前列醇),观察3 组治疗效果和不良反应情况。结果 A、B、C 3 组完全流产率分别为64.06%(82/128)、87.50%(112/128)、66.19%(92/139),B 组与其他两组差异有统计学意义(χ² 值＝21.450,P< 0.05);A 组与C 组比较,差异无统计学意义。B 组患者平均阴道出血量为(102.56±54.32)mL,明显高于其他两组的(80.24±48.97)mL 和(54.75±34.87)mL,差异有统计学意义(P< 0.05);A、B、C 3 组患者平均排胎时间分别为(12.78±4.89)、(13.59±5.87)、(13.47±4.21)h,差异无统计学意义;A、B、C 3 组患者不良反应率分别为50.78%、54.69%和44.60%,差异无统计学意义,3 组患者均未经特殊处理,症状自行缓解消失,无严重并发症出现。结论 米索前列醇联合米司非酮治疗妊娠10～16 周稽留流产能提高完全流产率,排胎时间与终止妊娠患者相当,且未增加不良反应的发生率。米索前列醇联合米司非酮治疗患者阴道出血量有所增多,但在正常范围内。

Objective To observe and analyze the efficacy and safety of misoprostol combined with mifepristone in the treatment of missed abortion during pregnancy of 10—16 weeks. Methods The missed abortion patients (256 cases) during pregnancy of 10—16 weeks of and patients (139 cases) with termination of pregnancy in 10—16 weeks in obstetrics and gynecology department from January 2010 to June 2013 in Hospital of Qinhuangdao Economic & Technological Development Zone were chosen, The missed abortion patients were randomly divided into group A (given misoprostol) and group B (given misoprostol combined with mifepristone), and patients with termination of pregnancy were in group C (given misoprostol). The effects and adverse reactions in three groups of misoprostol combined with mifepristone after the treatment were observed. Results The complete abortion rates in group A—C were 64.06% (82/128), 87.50% (112/128), and 66.19% (92/139), with statistically significant difference (χ² = 21.450, P < 0.05); Compared with group C, group A had no significant difference (χ² = 0.133, P>0. 0.05); The average amount of vaginal bleeding in group B was (102.56 ± 54.32) mL, significantly higher than those in the other two groups (80.24 ± 48.97 and 54.75 ± 34.87 mL), and the difference was statistically significant (P < 0.05); The average delivery time in three groups was 12.78 ± 4.89, 13.59 ± 5.87,and 13.47 ± 4.21 h, without significant difference (P>0. 0.05); The adverse reaction rates of three groups of patients were 50.78%, 54.69% and 44.60%, without significant difference (χ² = 2.772, P>0. 0.05), Three groups of patients did not receive special treatment, the symptoms alleviated spontaneously and disappeared, and no serious complications occurred. Conclusion The same dose of misoprostol combined with mifepristone in treatment of missed abortion of 10—16 weeks pregnancy and termination of pregnancy has the same curative effect. The appropriate increase of mifepristone dose can improve the treatment efficacy, but do not increase the adverse reaction occurrence, while the vaginal bleeding volume of patients will increase.