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1、米索前列醇在妇产科临床应用【摘要】米索前列醇是人工合成的前列腺素E1的衍生物,有多方面的临床用处,20世纪80年代早期米索前列醇最先用于消化性溃疡,80年代以后米索前列醇与米非司酮配伍用于抗早孕,可使完全流产率大大提高。近几年广泛应用于妇产科领域,如人工流产、上环、取环、诊断性刮宫、术前或口服阴道用药,起到扩张宫颈的作用,减少受术者的痛苦。米索前列醇用药中期引产,局部用药增加引产的效果,死胎引产成功率可达百分之百;用于足月妊娠诱发宫缩可缩短产程,预防剖宫产术后出血;治疗产后大出血有明显的效果。米索前列醇的主要作用是促进宫颈成熟,诱导分娩,减少产后出血,给药途径不同,产
2、生的效果也不相同,口服吸收迅速,30min达到血药浓度高峰,血浆清除半衰期为1.5h,局部用药副作用小、吸收快,直接作用于宫颈。米索前列醇具有应用简便、效果可靠、易掌握、安全、副作用小、价格低的特点,适用于各级医院,尤其是基层医院,对减少产后出血的发生率,减低孕产妇死亡率,减少出血用量均有重要意义。【关键词】米索前列醇;早期流产;中期引产;死胎引产;产后出血预防ApplicationofMisoprostolinclinicalGynaecology10SHIXueyunXiqinWomenandchildren’sHealthClinic,300380,Tianji
3、n【Abstract】MisoprostolisthederivativesofsynthesizedprostaglandinE1andhasawiderangeofapplicationinclinics.Itisusedinthetreatmentofdigestiveulcerintheearly1980s,andthencombinedwithMifepristoneinthepreventionofearlypregnancyandabortioninthelate1980s.Inrecentyears,misoprostoliswidelyuseding
4、ynaecologyandobstetrics,suchasartificialabortion,putting-inandtaking-outofintrauterinedevice,diagnosticdilatationandcurettage,pre-operationalvaginalmedicationforthepurposeofcervixdilatationandpainrelieving.Inthecaseofmiddle-termpregnancytermination,localadministrationofmisoprostolcouldi
5、mprovetheefficacyoftermination,andensurethe100%terminationsuccessrate.Whenmisoprostolisusedinfull-termdelivery,itcanstimulateUterineSpasm,shortendeliveryprocess,andpreventthehemorrhageaftercesareansection.Itcanalsohave10goodeffectsonthetreatmentofpostpartumhemorrhage.Inconclusion,themai
6、nfunctionofmisoprostolistoacceleratecervixmaturity,tofacilitatedelivery,toreducetheriskofpostpartumhemorrhage.Theeffectsofmisoprostolcanbedifferentinaccordancewithdifferentmedicationmeans.Oralmedicationcouldleadtoquickabsorption,reachinghighestdrugconcentrationafter30minutes,andhaving15
7、hoursofeliminationhalf-life.Localmedicationcanbedirectlyappliedtocervix,producingsmallersideeffectsandquickabsorptionrate.Useofmisoprostolisconvenient,reliable,safe,inexpensiveandlowinsideeffects,andthereforeissuitableforapplicationingynaecologyandobstetrics.【Keywords】Misoprost
