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目的 :探索米非司酮合并米索前列腺醇 (米索 )终止 10～ 16周妊娠最佳剂量及最佳给药途径。方法 :将来自上海 2 4所医院的 2 0 0 7例孕 10～ 16周要求药物终止妊娠的妇女 ,随机分成 4种不同的治疗组。组Ⅰ :5 11例 ,米非司酮 75mg每天 1次 ,连服 2d(总量 15 0mg) ,第 3天晨口服米索 0 .6mg ,每 3～ 4h重复 1次 ,最多 3次 ;组Ⅱ :491例 ,米非司酮 10 0mg每天 1次 ,连服 2d(总量 2 0 0mg) ,米索用法同组Ⅰ ;组Ⅲ :5 19例 ,米非司酮用法同组Ⅰ ,第 3天晨阴道内放置米索 0 .6mg ,每 12h重复 1次 ,最多 3次 ;组Ⅳ :486例 ,米非司酮用法同组Ⅱ ,米索用法同组Ⅲ。结果 :4组 2 4h内的流产成功率分别为 88.6 %、89 .4%、90 .9%和 94.0 %。组Ⅳ的成功率明显高于组Ⅰ和组Ⅱ。 2 4h内流产成功者米索的用量 ,阴道给药者比口服给药者明显减少 (P <0 .0 0 1) ,胃肠道副反应发生率也明显降低 (P <0 .0 5 )。结论 :口服米非司酮 2 0 0mg合并阴道放置米索 ,是较好的药物终止 10～ 16周妊娠的方法 ,可作为一种常规方法推荐在临床使用。
Objective: To explore the optimal dose of mifepristone combined with misoprostol (misoprostol) to terminate the pregnancy of 10 ~ 16 weeks and the optimal route of administration. Methods: A total of 270 cases of pregnant women who required termination of pregnancy from 10 to 16 weeks’ gestation in 24 hospitals in Shanghai were randomly divided into 4 different treatment groups. Group Ⅰ: 5,111 cases, mifepristone 75mg once daily for 2d (total 150mg), on the 3rd day morning oral misoprostol 0.6mg, once every 3 ~ 4h, up to 3 times; group Ⅱ: 491 cases, mifepristone 10mg once daily, even for 2d (a total of 200mg), misoprostol group I; group Ⅲ: 519 cases, mifepristone use the same group Ⅰ, 3 days morning vaginal placed Miso 0. 6mg, repeated once every 12h, up to 3 times; Group Ⅳ: 486 cases, mifepristone use the same group Ⅱ, misoprostol group Ⅲ. Results: The success rates of abortion within 24 hours were 88.6%, 89.4%, 90.9% and 94.0% respectively in 4 groups. The success rate of group Ⅳ was significantly higher than that of group Ⅰ and group Ⅱ. The dosage of misoprostol for successful abortion in 24 h was significantly lower in vaginal administration than that in oral administration (P0.01), and the incidence of gastrointestinal side effects was also significantly decreased (P0.05) . Conclusion: Mifepristone 200 mg combined with vaginal misoprostol is a good method to terminate the pregnancy of 10-16 weeks. It can be recommended as a routine method for clinical use.