Effects of estradiol and progesterone combined with curettage on missed abortion and intrauterine tissue adhesion
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摘要:
目的 研究雌孕激素药物联合清宫术治疗稽留流产及防治宫内组织粘连的效果。 方法将2017年3月~2018年3月间本院妇科收治的84例稽留流产患者采用随机数字表法分为对照组(n=42)和观察组(n=42)。对照组患者行宫腔镜清宫术,观察组患者于清宫术前口服戊酸雌二醇片,清宫术后口服左炔诺孕酮炔雌醇片。术后随访3月,比较两组患者阴道流血时间、月经复潮时间、子宫内膜厚度以及术后宫内组织粘连发生率和严重程度。 结果 观察组与对照组患者术后阴道流血时间和清宫术中吸宫次数比较差异无统计学意义(P>0.05);观察组术后月经复潮时间少于对照组(24.46±4.15 d vs 39.89±4.85 d),术后14 d子宫内膜厚度大于对照组(7.79±2.06 mm vs 4.89±1.69 mm,P<0.05);观察组与对照组患者清宫术后3月内宫内组织粘连率分别为4.76%与21.43%,差异有统计学意义(P<0.05),两组宫内组织粘连严重程度比较差异无统计学意义(P>0.05);观察组和对照组治疗后并发症发生率差异无统计学意义(P>0.05)。 结论 雌孕激素联合清宫术治疗稽留流产可缩短术后阴道出血时间,促进子宫内膜修复,减少宫内组织粘连。 Abstract:Objective To explore the effect of estrogen and progesterone combined with curettage on missed abortion and prevention of intrauterine adhesion. Methods A total of 84 cases of missed abortion in obstetrics department of our hospital from March 2017 to March 2018 were selected as the research object. All patients were divided into control group(n=42)and observation group(n=42)according to random number table method. Patients in the control group were given hysteroscopic hysterectomy, and patients in the observation group were treated with estradiol valerate tablets before operation and levonorgestrel ethinylestradiol tablets after operation. After 3 months follow-up, the time of vaginal bleeding, menstruation, endometrial thickness, incidence and severity of intrauterine adhesion were compared between the two groups. Results The differences of vaginal bleeding time after operation and the number of uterine aspiration between observation group and control group were not significant(P>0.05). The menstruation time in the observation group was significantly shorter than that in the control group(24.46±4.15 d vs 39.89±4.85 d). The postoperative 14 d endometrial thickness was significantly greater than that in the control group(7.79±2.06 mm vs 4.89±1.69 mm, P<0.05). The intrauterine tissue adhesion rates within 3 months after the operation of the observation group and the control group were 4.76%(2/42)and 21.43%(9/42), respectively(P<0.05). The difference of the severity of intrauterine tissue adhesion between the two groups was not significant(P>0.05). The incidences of complications in the observation group was not different from the control group(P>0.05). Conclusion Estrogen and progesterone combined with curettage for missed abortion can significantly shorten the postoperative vaginal bleeding time, promote endometrial repair and reduce intrauterine tissue adhesion. -
Key words:
- missed abortion /
- estrogen /
- progestogen /
- curettage /
- intrauterine tissue adhesion
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表 1 两组阴道流血时间、月经复潮时间、子宫内膜厚度、吸宫次数比较(Mean±SD,n=42)
组别 阴道流血时间(d) 月经复潮时间(d) 子宫内膜厚度(mm) 清宫术中吸宫次数 对照组 5.82±1.38 39.89±4.85 4.89±1.69 2.56±0.47 观察组 5.48±1.26 24.46±4.15 7.79±2.06 2.44±0.42 t 1.179 14.651 7.053 1.238 P 0.242 0.000 0.000 0.221 表 2 两组宫内组织粘连率与粘连程度比较(n=42)
组别 粘连发生率(%) 粘连程度[n(%)] 轻度 中度 重度 对照组 21.43(9/42) 4(9.52) 3(7.14) 2(4.76) 观察组 4.76(2/42) 2(4.76) 0(0.00) 0(0.00) χ2/U 5.126 1.173 P 0.023 0.241 -
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