1118例早孕药物流产效果影响因素的研究

Influencing factors of early medical abortion outcomes in 1 118 cases

目的探讨影响药物流产效果的相关因素，以便更好地指导临床用药。方法选择2009年1月至2012年10月于上海市松江区九亭医院妇产科门诊就诊的患者，以药物流产后因不全流产或流产失败行手术干预的患者为病例组，药物流产后流产完全的患者为对照组，分析药物流产后需要手术干预的相关影响因素。结果孕妇的年龄（OR=1．34，χ^2=2．97，P〉0．05）、剖宫产史（DR=1．34,χ^2=3．60，P〉0．05）、流产史（χ^2=3．35，P〉0．05）与手术干预率没有显著关系；孕妇的妊娠史（χ^2=19．50，P〈0．01）、药流前B超显示的孕囊平均直径（DR=2．04，χ^2=19．20，P〈0．05）、子宫位置（OR=3．53，χ^2=39．57，P〈0．05）与手术干预率有显著关系。结论孕妇的妊娠史、药流前B超示孕囊平均直径、屈位子宫是影响早孕药物流产成功的主要因素。

Objective To investigate the correlative factors of affecting the outcomes of early medical abortion, so as to provide basis for clinical medication. Methods Out-patient cases treated in Jiuting Hospital of Songjiang District between January 2009 and October 2012 were selected. Women suffering from failed medical abortion and requiring an additional surgical treatment were enrolled in case group, while women with successful abortion were enrolled in control group. The correlative influencing factors of medical abortion requiring additional surgical treatment were evaluated. Results The age of women （ OR = 1.34, χ^2 = 2.97, P 〉 0. 05 ）, history of caesarean section （ OR = 1.34, χ^2 = 3.60, P 〉 0.05 ）, and history of abortion （χ^2= 3.35, P 〉 0.05 ） did not have significant relationship with surgical treatment rate, but the history of pregnancy （χ^2= 19.50 ,P 〈 0.01 ）, the average diameter of gestational sac revealed by B-uhrasonography （ OR = 2.04, χ^2 = 19.2, P 〈 0.05 ） and the position of uterus （ OR = 3.53 ,χ^2= 39.57, P 〈 0.05 ） had significant relationship. Conclusion The history of pregnancy, the average diameter of gestational sac revealed by B-ultrasonography and the uterine flexion are the primary factors that influence the outcomes of early medical abortion.