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[两次流产技术的临床结果,特别关注上行性生殖道感染]

[Clinical results of two-time abortion technics with special regard to ascending genital infections].

作者信息

Kreibich H, Ehrig E, Koch E

出版信息

Zentralbl Gynakol. 1977;99(12):755-62.

PMID:331753
Abstract

If risk of the one-time mechanical dilatation will be too high (with young first gravidae and progressed pregnancy) the methods of the two-time interruptio should be applied. As long as there will not be available sufficient quantities of Prostaglandin-analoga the present method of choice is the abort-induction by means of the extra-amnial application of Prostaglandin F2alpha. In 101 cases when extra-amnial Pg F2alpha with an average induction time of four hours, the contamination rate was checked and no danger of ascension appeared. If prostaglandines will not be available, metranoicter or laminarias should be applied in the first trimenon when there is a high risk of dilatation, in the second trimenon extra-amnial instillation methods should be used. In both the cases only can be spoken of interruptios low if risks of they are made up under guard of broad spectrum antibiotics--after negative proof of blastomyces (buddings). This recommendation results from microbiological researches made up with 423 patients under the aspect of possible hospital infections. With induction times longer than 18 hours, the cavum uteri proved accelerating contaminated microbially. There were found microbes in the cavum uteri respectively at laminarias and metranoicters of, enterobacteria (45,7%), staphylococci (24,7%), hemolyzing and anhemolytic streptococci (17,6%), enterococci (8,0%), Corynebacteria (3,0%) and blastomyces (buddings) (1,0%).

摘要

如果一次性机械扩张的风险过高(初产妇年轻且妊娠进展),应采用两次引产的方法。只要没有足够数量的前列腺素类似物,目前的首选方法就是通过羊膜外应用前列腺素F2α来引产。在101例平均引产时间为4小时的羊膜外应用前列腺素F2α的病例中,检查了污染率,未出现上行感染的危险。如果没有前列腺素,在妊娠早期扩张风险高时应使用米索前列醇或海藻棒,在妊娠中期应采用羊膜外滴注法。在这两种情况下,只有在广谱抗生素的保护下,且芽生菌检测为阴性后,才能认为引产风险低。这一建议是基于对423例患者进行的关于可能的医院感染的微生物学研究得出的。引产时间超过18小时时,子宫腔被证明微生物污染加速。在使用海藻棒和米索前列醇的子宫腔中分别发现了微生物,包括肠杆菌(45.7%)、葡萄球菌(24.7%)、溶血和不溶血链球菌(17.6%)、肠球菌(8.0%)、棒状杆菌(3.0%)和芽生菌(芽)(1.0%)。

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