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人工流产术后预防宫腔粘连措施的比较

[Comparison among measures to prevent intrauterine adhesions after artificial abortion].

作者信息

Li Lei, Nai Manman, Gao Guixiang, Wang Luwen

机构信息

Department of Obstetrics and Gynecology, Third Affiliated Hospital, Zhengzhou University, Zhengzhou 450000, China

Department of Obstetrics and Gynecology, Third Affiliated Hospital, Zhengzhou University, Zhengzhou 450000, China.

出版信息

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2016 Sep 28;41(9):975-8. doi: 10.11817/j.issn.1672-7347.2016.09.013.

Abstract

OBJECTIVE

To investigate the clinical efficacy of oral medicine and sodium hyaluronate in prevention of intrauterine adhesions after artificial abortion.

METHODS

A total of 572 patients with early pregnancy termination through artificial abortion, who experienced two or more times of abortion, were retrospectively analyzed. Patients were randomly and voluntarily divided into 4 groups: an artificial cycle group, a drospirenone and ethinylestradiol tablets group, a sodium hyaluronate group, and a control group. The thickness of the endometrium, return time of menses, and the status of intrauterine adhesions were observed.

RESULTS

The thickness of the endometrium in the artificial period group was greater than that in the control group (P<0.001). It was less in the drospirenone and ethinylestradiol tablets group comparing with that in the control group (P<0.001). There was no significant difference in the thickness of the endometrium between the sodium hyaluronate group and the control group (P=0.717). Return time of menses in the artificial menstrual cycle group and the drospirenone and ethinylestradiol tablets group was shorter than that in the control group (P<0.001). There was no significant difference in return time of menses between the sodium hyaluronate group and the control group (P=0.813). The incidence of intrauterine adhesions could be reduced by the 3 preventive measures (All P<0.01).

CONCLUSION

Drugs for artificial cycle and drospirenone and ethinylestradiol tablets medication immediately after artificial abortion can effectively promote endometrial repair and reduce the incidence of intrauterine adhesions. However, for the patients with poor compliance, drospirenoneand ethinylestradiol tablets are the first choice for prevention of intrauterine adhesion.

摘要

目的

探讨口服药物及透明质酸钠预防人工流产术后宫腔粘连的临床疗效。

方法

回顾性分析572例有两次及以上人工流产史的早期妊娠行人工流产终止妊娠的患者。患者随机自愿分为4组:人工周期组、炔雌醇环丙孕酮片组、透明质酸钠组和对照组。观察子宫内膜厚度、月经复潮时间及宫腔粘连情况。

结果

人工周期组人工周期时子宫内膜厚度大于对照组(P<0.001)。炔雌醇环丙孕酮片组子宫内膜厚度小于对照组(P<0.001)。透明质酸钠组与对照组子宫内膜厚度比较差异无统计学意义(P=0.717)。人工周期组和炔雌醇环丙孕酮片组月经复潮时间短于对照组(P<0.001)。透明质酸钠组与对照组月经复潮时间比较差异无统计学意义(P=0.813)。3种预防措施均可降低宫腔粘连发生率(均P<0.01)。

结论

人工流产术后立即采用人工周期药物及炔雌醇环丙孕酮片可有效促进子宫内膜修复,降低宫腔粘连发生率。但对于依从性差的患者,炔雌醇环丙孕酮片是预防宫腔粘连的首选药物。

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