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目的研究妊娠60～70d具有人工流产高危因素者,包括瘢痕子宫、哺乳期、宫颈发育不良、初次妊娠年龄16～18周岁的患者如何更安全、无痛苦地选择终止妊娠的方法。方法通过100例具有上述条件的患者常规实施无痛负压吸宫术,另100例具有上述条件的患者术前1d给予米非司酮75mg,12h口服1次。次晨空腹舌下含服米索前列酮0.6mg,2h后实施无痛刮宫术,观察术中失血量、手术时间、宫颈扩张情况宫缩幅度及术后阴道流血时间的差异。结果无痛刮宫术术前给药者,术中失血量少,易操作,损伤小,手术时间短,术后阴道流血少。结论在无痛人流的基础上加用低剂量的米非司酮、米索前列醇既不增加患者费用,又避免了全程服用药物终止妊娠给患者造成的长时间的恶心、呕吐、腹痛等痛苦,具有低损伤、低风险的优点,是一种值得推广的好方法。
Objective To study how to choose the termination of pregnancy more safely and painlessly in patients with first trimester of pregnancy aged 16-18 years who have high risk factors of induced abortion from 60 to 70 days of gestation, including scar uterus, lactation, cervical dysplasia. Methods 100 patients with the above conditions were routinely treated with painless vacuum aspiration, and another 100 patients with the above conditions were given mifepristone 75 mg 1 d before operation and once daily for 12 h. The next morning fasting sublingual misoprostol 0.6mg, 2h after the implementation of painless curettage, observation of intraoperative blood loss, operation time, cervical dilatation and contraction rate of vaginal bleeding after the time difference. Results Painless curettage premedication, intraoperative blood loss less easy to operate, less injury, shorter operative time, fewer postoperative vaginal bleeding. Conclusions Adding low doses of mifepristone and misoprostol on a painless basis not only increases patient costs but also avoids prolonged nausea, vomiting, abdominal pain and other pains caused by the termination of pregnancy by the medication , With the advantages of low damage, low risk, is a good way to promote.