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目的比较甲氨蝶呤与米非司酮及米索前列醇并用进行药物流产的疗效。方法对 12 8例妊娠≤ 49天 ,要求药物终止妊娠的妇女分两组。对照组 5 0例 :米非司酮 2 5 mg口服每 12小时 1次 ,共 6次 (15 0 mg) ,第 4天上午口服米索前列醇 0 .6mg;观察组 78例 :第 1天上午加服甲氨蝶呤 2 5 mg,其余方法同对照组。并选择停经≤ 45天观察组、对照组各 3 0例于胚囊排出第 5、15、2 5天测定血清 HCG值。结果观察组与对照组完全流产率分别为 97.44 %和 88.0 0 % (P<0 .0 5 ) ,胚囊 6小时内排出率分别为 98.68%和 88.64 % (P<0 .0 5 )。完全流产后阴道出血天数为 7.3 3± 1.98和 11.3 6± 5 .0 3 (P<0 .0 1)。7天内阴道流血干净率为 63 .16%和 2 5 .0 0 % (P<0 .0 1)。两组副作用比较 ,无显著性差异 (P>0 .0 5 )。两组血清 HCG变化第 15天、第 2 5天比较有显著性差异 (P<0 .0 1)。结论甲氨蝶呤与米非司酮及米索前列醇并用 ,可提高完全流产率 ,缩短药物流产后出血时间 ,且不增加副作用。
Objective To compare the efficacy of methotrexate with mifepristone and misoprostol for medical abortion. Methods A total of 12 8 pregnant women ≤ 49 days of pregnancy requiring termination of pregnancy were divided into two groups. Control group of 50 cases: mifepristone 25 mg orally every 12 hours once a total of 6 times (15 0 mg), the morning of the 4th morning misoprostol 0.6 mg; observation group 78 cases: the first day Add methotrexate 25mg in the morning, the rest of the method with the control group. The serum HCG levels were determined on the 5th, 15th and the 25th day after the embryo sac was discharged from the observation group and the control group with 30 days of menopause ≤ 45 days. Results The complete abortion rates of the observation group and the control group were 97.44% and 88.0% respectively (P0.05), and the rates of intrauterine embryo sac effusion within 6 hours were 98.68% and 88.64% (P0.05) respectively. Vaginal bleeding days after complete abortion were 7.3 3 ± 1.98 and 11.3 6 ± 5 .0 3 (P <0.01). The vaginal bleeding rate was 63.16% and 25.0% (P <0.01) within 7 days. There was no significant difference between the two groups in side effects (P> 0.05). Serum HCG changes between the two groups on the 15th and the 25th days were significantly different (P <0.01). Conclusions Combined use of methotrexate and mifepristone and misoprostol can increase the rate of complete abortion and shorten the bleeding time after medical abortion without increasing the side effects.