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四种药物联合方案与刮宫术治疗不全流产的疗效比较:一项前瞻性观察研究。

Efficacy of a four-drug combined regimen compared to uterine curettage in the treatment of incomplete medical abortion: a prospective observational study.

作者信息

Feng Yanlin, Zhang Linai

机构信息

Department of Family Planning, Children's Hospital of Shanxi, Women Health Center of Shanxi, No. 3 Xinmin North Street, Taiyuan City, Shanxi Province, 030001, China.

出版信息

J Health Popul Nutr. 2025 Apr 9;44(1):111. doi: 10.1186/s41043-025-00771-z.

Abstract

OBJECTIVE

To investigate the clinical efficacy of the combined regimen of four drugs (drospirenone and ethinylestradiol tablets (II), mifepristone, misoprostol, and Xinshenghua granules) for the treatment of incomplete medical abortion (MA).

METHODS

184 patients diagnosed with incomplete MA were recruited and divided into two groups: the combined medication group (n = 92) and the uterine curettage group (n = 92). Patients in the combined medication group were treated with a combined regimen of four drugs, while those in the uterine curettage group were treated with uterine curettage.

RESULTS

After treatment, the diameter of residue (0.00 VS 4.26 ± 2.34 mm, t=-3.359, P = 0.010), days of vaginal bleeding (9.79 ± 1.76 VS 11.92 ± 1.91 days, t=-4.688, P = 0.010) and return time of menses (28.58 ± 2.67 VS 31.24 ± 2.43 days, t=-4.238, P < 0.001) of the combined medication group were significantly lower than those of the uterine curettage group. The duration of menstruation (6.12 ± 1.12 VS 5.11 ± 0.98 days, t=-2.681, P = 0.007) and the proportion of menstrual volume equal to past menstruation after return of menses were higher in the combined medication group than in the uterine curettage group (80.43% VS 57.61%, χ = 16.472, P < 0.001). No statistically significant difference was observed between the two groups in terms of serum β-HCG levels after treatment (P > 0.05); the overall response rate was higher in the combined medication group than in the uterine curettage group (97.83% VS 80.43%, χ = 54.331, P < 0.001). No adverse reaction events occurred during the treatment.

CONCLUSION

The combined regimen of four drugs boasts favorable efficacy for the treatment of incomplete MA, and is equally efficient as compared to uterine curettage.

摘要

目的

探讨炔雌醇环丙孕酮片(Ⅱ)、米非司酮、米索前列醇和新生化颗粒四联方案治疗药物流产不全的临床疗效。

方法

选取184例诊断为药物流产不全的患者,分为联合用药组(n = 92)和清宫组(n = 92)。联合用药组患者采用四联方案治疗,清宫组患者采用清宫治疗。

结果

治疗后,联合用药组的残留直径(0.00对4.26±2.34mm,t = -3.359,P = 0.010)、阴道出血天数(9.79±1.76对11.92±1.91天,t = -4.688,P = 0.010)和月经恢复时间(28.58±2.67对31.24±2.43天,t = -4.238,P < 0.001)均显著低于清宫组。联合用药组的月经持续时间(6.12±1.12对5.11±0.98天,t = -2.681,P = 0.007)和月经恢复后月经量与既往月经量相等的比例高于清宫组(80.43%对57.61%,χ = 16.472,P < 0.001)。两组治疗后血清β-HCG水平差异无统计学意义(P > 0.05);联合用药组的总有效率高于清宫组(97.83%对80.43%,χ = 54.331,P < 0.001)。治疗期间未发生不良反应事件。

结论

四联方案治疗药物流产不全疗效良好,与清宫术疗效相当。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c91/11983879/0b5e514ffe2b/41043_2025_771_Fig1_HTML.jpg

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