试论药流与吸宫术对疤痕子宫再次妊娠早期终止安全性比较
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论文导读：fferencesintherateofabnormalvaginalbleedingamountandabnormalbleedingtimeandabortionratebetweenusingdrugsanduterineaspirationfortheterminationofscaruterusrepregnancy，butusingtheformerwaycanoidthehighincidenceofcomplicationscausedbyuterineaspirationwithh
[摘要] 目的 探讨药流与吸宫术对疤痕子宫再次妊娠早期终止的安全性比较。策略 选取该院妇科门诊收治的要求终止早期妊娠的疤痕子宫妇女164例为研究对象，按入院顺序将患者随机分为观察组和对照组各82例。观察组采用药物米非司酮联合米索前列醇终止孕妇疤痕子宫再次早期妊娠，对照组采用吸宫术。观察两组孕妇治疗过程中出现的并发症，终止妊娠出血时间、出血量异常率，流产率等，进行统计学统计，比较两组治疗的安全性。结果 观察组孕妇采用药物终止早期妊娠的并发症发生率为9.76%明显低于对照组采用吸宫术孕妇28.05%，两组比较差异有统计学作用（P0.05）。结论 采用药物对疤痕子宫再次妊娠早期终止的出血量、出血时间异常率和流产率和吸宫术比较无明显差异；但是采用药物可以避开吸宫术而引起并发症的高发生率，药物流产的安全性高于吸宫术，值在临床推广。
[关键词] 米非司酮；米索前列醇；吸宫术；疤痕子宫；妊娠终止；安全性
[] A [文章编号] 1674-0742（2014）05（c）-0033-02
[Abstract] Objective To compare the safety between drug abortion and uterine aspiration for the early termination of scar uterus repregnancy. Methods 164 cases of pregnant women with scar uterus admitted in the gynecological outpatient of our hospital for early termination of pregnancy were selected as the subjects. And according to the order of admission， they were divided into the observation group and control group with 82 cases in each. The observation group was given mifepristone combined with misoprostol for the termination of scar uterus repregnancy， and the control group was given uterine aspiration. The complications occurred during the treatment， vaginal bleeding time after termination of pregnancy， abnormal bleeding rate， abortion rate and so on of both groups were observed and counted statistically， and the safety of the treatment of two groups was compared. Results The complication rate of the observation group using drugs to terminate early pregnancy was 9.76%， which was significantly lower than 28.05% of the control group using uterine aspiration， the difference was statistically significant（P0.05）. Conclusion There were no statistically significant differences in the rate of abnormal vaginal bleeding amount and abnormal bleeding time and abortion rate between using drugs and uterine aspiration for the termination of scar uterus repregnancy， but using the former way can oid the high incidence of complications caused by uterine aspiration with higher safety， so drug abortion is worthy of clinical application.
[Key words] Mifepristone； Misoprostol； Uterine aspiration； Scar uterus； Termination of pregnancy； Safety[3] Dabash R， Ramadan MC， Darwish EA randomized controlled trial of 400-μg sublingual misoprostol versus manual vacuum aspiration for the treatment of incomplete abortion in two Egyptian hospitals[J].Int J Gynaecol Obstet. 2010，111（2）：131-135.
[4] 冯玲. 米索前列醇立可灵在疤痕子宫早孕吸宫术中的应用[J].中国卫生产业，2012，10（16）：75.
[5] 陈美欢，刘， 聂莹.3种不同方式人工流产的临床研究[J].中国医疗前沿，2010，5（10）：40-41.
[6] 王甫娟.32例疤痕子宫产妇再次妊娠试产的临床分析[论文导读：例临床观察.中国保健营养，2013，24（5）：1183-1184.蔡惠兰，甘望农.终止疤痕子宫早期妊娠策略的安全性分析.咸宁学院学报，2011，25（6）：511-512.马素芬，李文智.不同剂量米非司酮配伍米索前列醇终止疤痕子宫妊娠60例临床分析.长治医学院学报，2004，20（3）：214-216.ZhuangY，QianZ，HuangL.Elevatedexpressionlev
J]. 检验医学与临床，2012，9（17）：2145-2146，2148.
[7] 周月英.药物联合清宫术在疤痕子宫早孕流产中的应用[J].安徽卫生职业技术学院学报，2012，11（5）：36-37.
[8] 孔熙.瘢痕子宫再次妊娠人工流产策略的疗效研究[J].中国医药科学，2013，3（9）：189-190.
[9] 朱学芳.药物流产和人工流产终止早孕180例临床观察[J].中国保健营养，2013，24（5）：1183-1184.
[10] 蔡惠兰，甘望农.终止疤痕子宫早期妊娠策略的安全性分析[J].咸宁学院学报，2011，25（6）：511-512.
[11] 马素芬， 李文智.不同剂量米非司酮配伍米索前列醇终止疤痕子宫妊娠60例临床分析[J].长治医学院学报，2004，20（3）：214-216.
[12] Zhuang Y， Qian Z， Huang L.Elevated expression levels of matrix metalloproteinase-9 in placental villi and tissue inhibitor of metalloproteinase-2 in decidua are associated with prolonged bleeding after mifepristone-misoprostol medical abortion[J].Fertil Steril，2013，5（13）：99. （收稿日期：2014-02-13）
[摘要] 目的 探讨药流与吸宫术对疤痕子宫再次妊娠早期终止的安全性比较。策略 选取该院妇科门诊收治的要求终止早期妊娠的疤痕子宫妇女164例为研究对象，按入院顺序将患者随机分为观察组和对照组各82例。观察组采用药物米非司酮联合米索前列醇终止孕妇疤痕子宫再次早期妊娠，对照组采用吸宫术。观察两组孕妇治疗过程中出现的并发症，终止妊娠出血时间、出血量异常率，流产率等，进行统计学统计，比较两组治疗的安全性。结果 观察组孕妇采用药物终止早期妊娠的并发症发生率为9.76%明显低于对照组采用吸宫术孕妇28.05%，两组比较差异有统计学作用（P0.05）。结论 采用药物对疤痕子宫再次妊娠早期终止的出血量、出血时间异常率和流产率和吸宫术比较无明显差异；但是采用药物可以避开吸宫术而引起并发症的高发生率，药物流产的安全性高于吸宫术，值在临床推广。
[关键词] 米非司酮；米索前列醇；吸宫术；疤痕子宫；妊娠终止；安全性
[] A [文章编号] 1674-0742（2014）05（c）-0033-02
[Abstract] Objective To compare the safety between drug abortion and uterine aspiration for the early termination of scar uterus repregnancy. Methods 164 cases of pregnant women with scar uterus admitted in the gynecological outpatient of our hospital for early termination of pregnancy were selected as the subjects. And according to the order of admission， they were divided into the observation group and control group with 82 cases in each. The observation group was given mifepristone combined with misoprostol for the termination of scar uterus repregnancy， and the control group was given uterine aspiration. The complications occurred during the treatment， vaginal bleeding time after termination of pregnancy， abnormal bleeding rate， abortion rate and so on of both groups were observed and counted statistically， and the safety of the treatment of two groups was compared. Results The complication rate of the observation group using drugs to terminate early pregnancy was 9.76%， which was significantly lower than 28.05% of the control group using uterine aspiration， the difference was statistically significant（P0.05）. Conclusion There were no statistically significant differences in the rate of abnormal vaginal bleeding amount and abnormal bleeding time and abortion rate between using drugs and uterine aspiration for the termination of scar uterus repregnancy， but using the former way can oid the high incidence of complications caused by uterine aspiration with higher safety， so drug abortion is worthy of clinical application.
[Key words] Mifepristone； Misoprostol； Uterine aspiration； Scar uterus； Termination of pregnancy； Safety[3] Dabash R， Ramadan MC， Darwish EA randomized controlled trial of 400-μg sublingual misoprostol versus manual vacuum aspiration for the treatment of incomplete abortion in two Egyptian hospitals[J].Int J Gynaecol Obstet. 2010，111（2）：131-135.
[4] 冯玲. 米索前列醇立可灵在疤痕子宫早孕吸宫术中的应用[J].中国卫生产业，2012，10（16）：75.
[5] 陈美欢，刘， 聂莹.3种不同方式人工流产的临床研究[J].中国医疗前沿，2010，5（10）：40-41.
[6] 王甫娟.32例疤痕子宫产妇再次妊娠试产的临床分析[论文导读：例临床观察.中国保健营养，2013，24（5）：1183-1184.蔡惠兰，甘望农.终止疤痕子宫早期妊娠策略的安全性分析.咸宁学院学报，2011，25（6）：511-512.马素芬，李文智.不同剂量米非司酮配伍米索前列醇终止疤痕子宫妊娠60例临床分析.长治医学院学报，2004，20（3）：214-216.ZhuangY，QianZ，HuangL.Elevatedexpressionlev
J]. 检验医学与临床，2012，9（17）：2145-2146，2148.
[7] 周月英.药物联合清宫术在疤痕子宫早孕流产中的应用[J].安徽卫生职业技术学院学报，2012，11（5）：36-37.
[8] 孔熙.瘢痕子宫再次妊娠人工流产策略的疗效研究[J].中国医药科学，2013，3（9）：189-190.
[9] 朱学芳.药物流产和人工流产终止早孕180例临床观察[J].中国保健营养，2013，24（5）：1183-1184.
[10] 蔡惠兰，甘望农.终止疤痕子宫早期妊娠策略的安全性分析[J].咸宁学院学报，2011，25（6）：511-512.
[11] 马素芬， 李文智.不同剂量米非司酮配伍米索前列醇终止疤痕子宫妊娠60例临床分析[J].长治医学院学报，2004，20（3）：214-216.
[12] Zhuang Y， Qian Z， Huang L.Elevated expression levels of matrix metalloproteinase-9 in placental villi and tissue inhibitor of metalloproteinase-2 in decidua are associated with prolonged bleeding after mifepristone-misoprostol medical abortion[J].Fertil Steril，2013，5（13）：99. （收稿日期：2014-02-13）