稽留流产患者清宫术后口服避孕药的临床疗效评价
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摘要
目的:探讨稽留流产患者实施清宫术后口服避孕药的临床疗效。方法:选取本院妇产科2017年1—12月收治的80例稽留流产患者,按随机数字表法分为常规组和干预组,各40例。两组均实施常规清宫术。术后,常规组运用抗生素及益母草治疗,干预组在常规组的基础上采取口服避孕药(屈螺酮炔雌醇片)治疗,分析两组患者术后恢复、性激素水平变化、术后并发症、术后6个月再妊娠及再稽留流产状况。结果:干预组阴道持续性流血时间、月经复潮时间均明显短于常规组,差异均有统计学意义(P<0.05)。术后2周,干预组子宫内膜厚度、雌二醇均高于常规组,而黄体生成素、孕酮均低于常规组,差异均有统计学意义(P<0.05)。干预组术后2周卵泡刺激素与常规组比较,差异无统计学意义(P>0.05)。干预组术后盆腔感染、宫内残留胚胎组织、宫腔粘连发生率均明显低于常规组,差异均有统计学意义(P<0.05)。两组患者用药期间均未出现明显不良反应症状,且干预组术后3个月体质量增加量与常规组比较,差异均无统计学意义(P>0.05)。干预组术后6个月再妊娠率与常规组比较,差异无统计学意义(P>0.05),但干预组术后6个月再稽留流产率明显低于常规组,差异有统计学意义(P<0.05)。结论:稽留流产患者实施清宫术后口服避孕药可促进患者早日恢复,并减少并发症,降低再稽留流产风险,改善预后,且用药安全性高。
Objective:To investigate the clinical effect of oral contraceptive in patients with missed abortion after curettage.Method:80 patients with missed abortion were selected from January to December 2017 in our hospital.They were divided into routine group and intervention group according to the random number table method,40 cases in each group.Both groups were given routine curettage.After curettage,the routine group was treated with antibiotics and Yimucao,and the intervention group was treated with oral contraceptive(Drospirenone and Ethinylestradiol Tablets)on the basis of the routine group.The postoperative recovery,sex hormone level,postoperative complications,repregnancy and missed abortion at 6 months after curettage in the two groups were analyzed.Result:The duration of continuous vaginal bleeding and menstrual resuscitation in the intervention group were significantly shorter than those in the routine group,the differences were statistically significant(P<0.05).2 weeks after curettage,the endometrial thickness,estradiol in the intervention group were significantly higher than those in the routine group,while luteinizing hormone and progesterone in intervention group were lower than those in routine group,the differences were statistically significant(P<0.05).There was no significant difference in follicle stimulating hormone between two groups 2 weeks after curettage,the difference was no statistically significant(P>0.05).The incidence of pelvic infection,intrauterine residual embryo tissue and intrauterine adhesion in the intervention group were significantly lower than those in the routine group,the differences were statistically significant(P<0.05).There were no obvious adverse reaction symptoms in the two groups during the treatment period,and there was no significant difference between two groups in the increase of body mass 3 months after curettage,the differences were no statistically significant(P>0.05).6 months after curettage,there was no significant difference in the rate of re-pregnancy between two groups(P>0.05),but the rate of recurrent abortion in the intervention group was significantly lower than that in the routine group,the difference was statistically significant(P<0.05).Conclusion:Oral contraceptive in patients with missed abortion after curettage can promote early recovery,reduce complications,reduce the risk of recurrent abortion and improve prognosis,and the safety of medication is high.
Objective:To investigate the clinical effect of oral contraceptive in patients with missed abortion after curettage.Method:80 patients with missed abortion were selected from January to December 2017 in our hospital.They were divided into routine group and intervention group according to the random number table method,40 cases in each group.Both groups were given routine curettage.After curettage,the routine group was treated with antibiotics and Yimucao,and the intervention group was treated with oral contraceptive(Drospirenone and Ethinylestradiol Tablets)on the basis of the routine group.The postoperative recovery,sex hormone level,postoperative complications,repregnancy and missed abortion at 6 months after curettage in the two groups were analyzed.Result:The duration of continuous vaginal bleeding and menstrual resuscitation in the intervention group were significantly shorter than those in the routine group,the differences were statistically significant(P<0.05).2 weeks after curettage,the endometrial thickness,estradiol in the intervention group were significantly higher than those in the routine group,while luteinizing hormone and progesterone in intervention group were lower than those in routine group,the differences were statistically significant(P<0.05).There was no significant difference in follicle stimulating hormone between two groups 2 weeks after curettage,the difference was no statistically significant(P>0.05).The incidence of pelvic infection,intrauterine residual embryo tissue and intrauterine adhesion in the intervention group were significantly lower than those in the routine group,the differences were statistically significant(P<0.05).There were no obvious adverse reaction symptoms in the two groups during the treatment period,and there was no significant difference between two groups in the increase of body mass 3 months after curettage,the differences were no statistically significant(P>0.05).6 months after curettage,there was no significant difference in the rate of re-pregnancy between two groups(P>0.05),but the rate of recurrent abortion in the intervention group was significantly lower than that in the routine group,the difference was statistically significant(P<0.05).Conclusion:Oral contraceptive in patients with missed abortion after curettage can promote early recovery,reduce complications,reduce the risk of recurrent abortion and improve prognosis,and the safety of medication is high.
引文
[1]范小玲,刘姿.孕早期稽留流产的病因分析及清宫术后用药评价[J].湖南师范大学学报(医学版),2017,14(1):72-74.
[2]李晓燕.透明质酸钠宫腔注入及戊酸雌二醇片口服减轻稽留流产患者术后宫腔粘连的效果及安全性研究[J].临床和实验医学杂志,2016,15(3):272-274.
[3]宋志秀,陈立霞,史建林,等.屈螺酮炔雌醇片对稽留流产清宫术后患者性激素及宫腔粘连的影响[J].宁夏医科大学学报,2018,40(2):189-191.
[4]吴玉芳.黄体酮和补佳乐对稽留流产清宫术后宫腔粘连的防治作用[J].中国保健营养,2016,26(27):43-44.
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[6]陈蕊,崔明双,李琴琴,等.宫腔镜配合药物治疗稽留流产43例临床观察[J].陕西医学杂志,2017,46(10):1404-1406.
[7]陶晓玲,张元珍,王燕,等.稽留流产术后早期随访对宫腔粘连的预防价值[J].中国计划生育和妇产科,2016,8(6):41-45.
[8]蒋琼,周芳.滋肾育胎丸联合戊酸雌二醇片治疗稽留流产术后月经过少60例临床分析[J].山西医药杂志,2016,45(24):2940-2942.
[9]刘建花,唐春洁.复方口服避孕药(COC)在稽留流产患者中的应用[J].中国生化药物杂志,2017,37(4):264-265.
[10]冯守凡.米非司酮与米索前列醇联合清宫术治疗稽留流产患者的临床疗效[J].中国药物经济学,2017,12(2):90-92.
[11]朱长远.B超监测下稽留流产清宫术后服用屈螺酮炔雌醇片对宫腔粘连的临床预防效果[J].中国生化药物杂志,2017,37(6):183-184,187.
[12]陈凤云.雌孕激素联合应用与清宫术治疗稽留流产后宫内组织残留的临床疗效[J].广州医科大学学报,2017,45(4):53-55.
[13]张艺玮,陈晶,潘晓伟.稽留流产不同治疗方式的临床观察[J].河北医药,2018,40(5):742-744.
[14]罗丽萍.B超监测下稽留流产清宫术后服用屈螺酮炔雌醇片对宫腔粘连的预防作用[J].当代医学,2016,22(8):133-134.
[15]刘颖蔚,赵纯全,赵玲.宫腔镜下清宫术联合雌孕激素预防稽留流产患者术后宫腔粘连的临床观察[J].中国药房,2018,29(2):220-223.
[16]许敬兰.宫腔镜手术与传统清宫术治疗稽留流产的效果比较[J].影像研究与医学应用,2018,2(11):166-167.
[17]刘普红.补佳乐联合黄体酮对稽留流产患者清宫术后宫腔粘连防治效果观察[J].青岛医药卫生,2017,49(6):428-430.
[18]吴超英,赵丹梅,李咏.芬吗通在稽留流产清宫术后的临床应用观察[J].中外女性健康研究,2016(17):160,172.
[19]钟树林,吴雪薇,陈颖诗,等.戊酸雌二醇联合地屈孕酮与清宫术治疗稽留流产后宫腔内组织残留的临床对照试验[J].新医学,2018,49(10):749-752.
[20]程丽琴,吴巧珠,陈凤英,等.稽留流产清宫术后使用小剂量戊酸雌二醇促进子宫内膜修复及降低宫腔粘连的疗效观察[J].中国医药科学,2017,7(3):94-96.
[21]陈丽敏,蒋春林,梁颖,等.应用超声观察加减归脾汤对稽留流产术后子宫内膜修复的影响[J].赣南医学院学报,2018,38(4):331-333.
[2]李晓燕.透明质酸钠宫腔注入及戊酸雌二醇片口服减轻稽留流产患者术后宫腔粘连的效果及安全性研究[J].临床和实验医学杂志,2016,15(3):272-274.
[3]宋志秀,陈立霞,史建林,等.屈螺酮炔雌醇片对稽留流产清宫术后患者性激素及宫腔粘连的影响[J].宁夏医科大学学报,2018,40(2):189-191.
[4]吴玉芳.黄体酮和补佳乐对稽留流产清宫术后宫腔粘连的防治作用[J].中国保健营养,2016,26(27):43-44.
[5]朱学芳,刘娟.米索前列醇与补佳乐合用治疗稽留流产的临床疗效分析[J].中国计划生育和妇产科,2017,9(3):72-74.
[6]陈蕊,崔明双,李琴琴,等.宫腔镜配合药物治疗稽留流产43例临床观察[J].陕西医学杂志,2017,46(10):1404-1406.
[7]陶晓玲,张元珍,王燕,等.稽留流产术后早期随访对宫腔粘连的预防价值[J].中国计划生育和妇产科,2016,8(6):41-45.
[8]蒋琼,周芳.滋肾育胎丸联合戊酸雌二醇片治疗稽留流产术后月经过少60例临床分析[J].山西医药杂志,2016,45(24):2940-2942.
[9]刘建花,唐春洁.复方口服避孕药(COC)在稽留流产患者中的应用[J].中国生化药物杂志,2017,37(4):264-265.
[10]冯守凡.米非司酮与米索前列醇联合清宫术治疗稽留流产患者的临床疗效[J].中国药物经济学,2017,12(2):90-92.
[11]朱长远.B超监测下稽留流产清宫术后服用屈螺酮炔雌醇片对宫腔粘连的临床预防效果[J].中国生化药物杂志,2017,37(6):183-184,187.
[12]陈凤云.雌孕激素联合应用与清宫术治疗稽留流产后宫内组织残留的临床疗效[J].广州医科大学学报,2017,45(4):53-55.
[13]张艺玮,陈晶,潘晓伟.稽留流产不同治疗方式的临床观察[J].河北医药,2018,40(5):742-744.
[14]罗丽萍.B超监测下稽留流产清宫术后服用屈螺酮炔雌醇片对宫腔粘连的预防作用[J].当代医学,2016,22(8):133-134.
[15]刘颖蔚,赵纯全,赵玲.宫腔镜下清宫术联合雌孕激素预防稽留流产患者术后宫腔粘连的临床观察[J].中国药房,2018,29(2):220-223.
[16]许敬兰.宫腔镜手术与传统清宫术治疗稽留流产的效果比较[J].影像研究与医学应用,2018,2(11):166-167.
[17]刘普红.补佳乐联合黄体酮对稽留流产患者清宫术后宫腔粘连防治效果观察[J].青岛医药卫生,2017,49(6):428-430.
[18]吴超英,赵丹梅,李咏.芬吗通在稽留流产清宫术后的临床应用观察[J].中外女性健康研究,2016(17):160,172.
[19]钟树林,吴雪薇,陈颖诗,等.戊酸雌二醇联合地屈孕酮与清宫术治疗稽留流产后宫腔内组织残留的临床对照试验[J].新医学,2018,49(10):749-752.
[20]程丽琴,吴巧珠,陈凤英,等.稽留流产清宫术后使用小剂量戊酸雌二醇促进子宫内膜修复及降低宫腔粘连的疗效观察[J].中国医药科学,2017,7(3):94-96.
[21]陈丽敏,蒋春林,梁颖,等.应用超声观察加减归脾汤对稽留流产术后子宫内膜修复的影响[J].赣南医学院学报,2018,38(4):331-333.