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1、联合用药用于稽留流产清宫术的疗效分析【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、2d单纯口服戊酸雌二醇，第3d行无痛清宫术，观察组第1、2d给予米非司酮加戊酸雌二醇口服，第3d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、术屮失血量均较对照组明显减少(P<0.001)o观察组术中需宫颈扩张、二次清宫及人工流产综合征发牛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
2、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艾献标识码:ADOI:10.3969/j.issn.10031383.2017.01.019Analysisofcurativeeffectofcombinationtherapyformissedabortioncurettage[HJ1*2][HJ]CHENLihua,HUANGLiqun,YEHuiyun,SUXianfei,WUTing(DepartmentofGy
3、necology,People'sHospitalofWuxuan,Wuxuan545900,China)[HJ2][HJ]【Abstract]ObjectiveToinvestigateclinicaleffectsofmifepristoneandmisoprostolcombinedwithestradiolvalerateformissedabortioncurettage・MethodsAtotalof92patientswithmissedabortionwererandomlydividedintotwogroups,with
4、46casesineachgroup.Thepatientsofcontrolgroupweregivenestradiolvalerateorallyonthefirstandsecondday,thentheyweregivencurettageoperationonthethirdday.Thepatientsofobservationgroupweregivenmifepristoneandestradiolvalerateorallyonthefirstandsecondday,andthentheyweregivenvagina
5、lmisoprostolonthethirddayaftergettingupinthemorning,andreceivedcurettageoperationintheafternoon.Clinicaleffectswerecomparedbetweenthetwogroups・ResuItsOperationtimeandbloodlossoftheobservationgroupweresignificantlylessthanthoseofthecontrolgroup(P〈0.001)•Intraoperativecervic
6、aldilatation,needtosecondclearin£uterusandabortionsyndromerateoftheobservationgroupweresignificantlylessthanthoseofthecontrolgroup,andthenaturalembryoremovalratewashigherthanthatofthecontrolgroup(P<0.05)・ConclusionMifepristoneandmisoprostolcombinedwithestradiolvaleratecani
7、ncreasenaturalembryoremovalrate,shortenoperationtimeandreducebloodloss,reducesecondclearinguterusrateandincideneeofcomplications・【Keywords］curettageoperation；mifepristone；misoprostol；estradiolvalerate；curettage稽留流?a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
8、流产增加剥离及刮宫难度，处理不当容易导致内膜损伤、彫响再次受孕等，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，且术屮术后并发症较多，近年来药物配合清宫术在稽留
