摘要
出血时间延长是米非司酮配伍前列腺素终止早孕最主要的副反应。本研究采用临床试验的方法对350例进行系统观察和分析。结果:该方法终止早孕的阴道出血时间平均12.8±5.9(2～43)天,呈左偏态单峰状分布,峰顶位于第9天。胎囊直径与出血时间呈正相关关系,r=0.169,P<0.01;正常经期>7天组出血时间(14.0±6.2天,n=74)明显长于<7天组(12.5±5.7天,n=276),P<0.05;口服前列腺素组的出血时间(14.1±5.4天,n=99)明显长于阴道给药组(12.3±6.0天,n=251),P<0.01。回归树型分析显示,胎囊大小是影响出血时间最重要的因素。当胎囊直径>12.5mm时出血时间较长。此时如经期<5天则出血时间仍较短,而经期≥5天出血时间较长。后者使用前列腺素阴道栓剂的出血时间短于口服。对这两种前列腺素给药途径可以进一步用胎囊大小判定,胎囊直径超过判定界值时出血时间较长,反之较短。该回归树揭示了上述各危险因素与出血时间延长的关系,并为临床医生确定最佳治疗方案提供了依据。
Long vaginal bleeding duration is one of the most important side effects on termination of early human pregnancy with mifeprostone and gemeprost. A clinical trial was designed to observe the side effect with 350 cases. The results showed vaginal bleeding duration was from 2 days to 43 days( 12. 8 ± 5. 9days) with single left shift peak distribution( peak = 9th day) . A positive correlation was found between diameter of blastula and bleeding duration, r=0.169,P<0.01. The vaginal bleeding duration in menstruation delay ( > 7 days) group (14.0 ± 6.2 days , n = 7 4 ) was significantlylonger than that in menstruation normal group (12.5 ± 5.7 days, n = 276), P < 0.05. The vaginal bleeding du ration in oral in taking gemeprost group (14. 1 ± 5. 4days, n = 99)was significantly longer than that in vaginal intaking gemeprost group ( 12. 3 ± 6. 0days, n = 251), P < 0. 01. Regression trees structure showed di-ameter of blastula was the most important risk factor of the side effect. The vaginal bleeding duration was longer when diameter of blastula was over 12. 5mm( 11,1 days vs 13.5 days). If cases were in later and menstruation longer( > 5 days), the vaginal bleeding duration would be longer( 14.1 ± 6.2 days, n = 181) . Then oral intaking gemeprost group( 16. 2 ± 5. 5 days, n = 45 ) had longer vaginal bleeding duration than vaginal intaking group (13.4 ±6.2 days, n = 136). At least, the diameter of blastula was applied to divide these cases into shorter and longer groups. The regression trees structure showed the relationship of the risk factors for the side effect. In clinic practice, it also contributed a few useful information for doctors to select a best treatment schedule, by lowest side effects, for each case.
出处
《中国计划生育学杂志》
1998年第3期114-115,共2页
Chinese Journal of Family Planning
关键词
出血时间延长
米非司酮
临床试验
终止早孕
Clinical trial Mifeprostone Regression trees Termination of early human pregnancy Long vaginal bleeding duration
