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目的观察戊酸雌二醇配伍米非司酮、米索前列醇在稽留流产中的临床疗效。方法将稽留流产患者84例随机分为治疗组和对照组各42例。治疗组患者先口服戊酸雌二醇5mg,每天3次,连服3d,第4天顿服米非司酮150mg,第6天服米索前列醇600μg。对照组患者空腹口服米非司酮50mg,每12小时1次,连续给药3d,第4天空腹口服米索前列醇600μg。观察2组患者口服米索前列醇后6h内胚胎娩出情况及出血量,服用米索前列醇6h后清宫,清宫后3d复查彩色多普勒超声检查有无残留。比较2组患者一次清宫和二次清宫情况。结果治疗组胚胎娩出比例明显高于对照组,娩出时间短于对照组,出血量少于对照组,一次清宫率高于对照组,二次清宫率低于对照组,差异均有统计学意义(P<0.05或P<0.01)。结论戊酸雌二醇配伍米非司酮、米索前列醇可明显提高胚胎娩出率,提高一次清宫率,而且可明显降低出血量,疗效显著,值得临床推广应用。
Objective To observe the clinical efficacy of valerate valerate in combination with mifepristone and misoprostol in missed abortion. Methods 84 patients with missed abortion were randomly divided into treatment group and control group, 42 cases each. Patients in the treatment group were orally given 5 mg estradiol valerate three times a day for 3 days. The patients in the treatment group received mifepristone 150 mg on the 4th day and 600 μg misoprostol on the 6th day. Patients in the control group were given mifepristone 50 mg on anabdominal fasting once every 12 hours for 3 days and on the 4th day, 600 μg of misoprostol was administered orally. Observed two groups of patients after oral administration of misoprostol within 6h after embryo delivery and bleeding, taking misoprostol 6h after the Qing, 3d after the review of color Doppler ultrasound examination for residual. Comparison of two groups of patients with a clear curettage and the second curettage situation. Results The rate of embryo delivery in the treatment group was significantly higher than that in the control group. The time of delivery was shorter than that of the control group. The amount of bleeding was less than that of the control group. The rate of one-stage curettage was higher than that of the control group, and the rate of second-stage curettage was lower than that of the control group P <0.05 or P <0.01). Conclusions estradiol valerate with mifepristone and misoprostol can significantly improve the rate of embryo delivery, increase the rate of one-stage curettage, and reduce the amount of bleeding significantly, which is worthy of clinical application.