地屈孕酮联合黄体酮对先兆流产保胎成功情况、激素水平、新生儿出生指标及疗效的影响和安全性研究

Study on the effect and safety of Dydrogesterone combined with Progesterone on the Success of fetal Protection,Hormone Level,neonatal Birth Index and curative effect in threatened Abortion

目的分析地屈孕酮加黄体酮对先兆流产患者保胎成功情况、激素水平、新生儿出生指标及疗效的影响和安全性。方法选取2019年6月至2021年6月漯河市妇幼保健院收治先兆流产合计112例患者,结合随机数字表法分成对照组(口服地屈孕酮)和观察组(在对照组治疗方法之上加以黄体酮肌注),各56例。统计并比较两组在不同治疗方案下的腰部酸痛缓解、腹痛缓解、孕酮恢复、止血时间和治疗费用;治疗前后的雌二醇(E2)、孕酮(P)、人绒膜促性腺激素(HCG)及孕激素诱导阻断因子(PIBF)等激素水平变化;新生儿畸形率、保胎成功率及新生儿体重;头晕、恶心、乳房胀痛、皮肤瘙痒等不良反应出现情况。结果观察组的腰部酸痛缓解、腹痛缓解、孕酮恢复、止血时间均短于对照组,治疗费用高于对照组,差异有统计学意义(P<0.05)。治疗前,两组的E2、P、HCG、PIBF水平相比,差异无统计学意义(P>0.05);治疗后,两组的E2、P、HCG、PIBF水平均较治疗前升高,且观察组的各项指标水平均高于对照组,差异有统计学意义(P<0.05)。两组的新生儿畸形率及新生儿体重相比,差异无统计学意义(P>0.05);观察组的保胎成功率高于对照组,差异有统计学意义(P<0.05)。两组头晕、恶心、乳房胀痛、皮肤瘙痒等不良反应出现相比,差异无统计学意义(P>0.05)。结论地屈孕酮加黄体酮对先兆流产患者疗效理想,能提升其保胎成功率,促进其激素水平恢复,改善新生儿出生指标,且安全性佳,值得应用到临床。

Objective To analyze the effect and safety of dydrogesterone and progesterone on the success of fetal protection,hormone level,neonatal birth index and curative effect in patients with threatened abortion.Methods A total of 112 patients with threatened abortion treated in Luohe maternal and child health Hospital from June 2019 to June 2021 were randomly divided into control group(oral dydrogesterone)and observation group(intramuscular injection of progesterone in addition to the control group),with 56 cases in each group.The two groups were statistically compared in terms of lumbar pain relief,abdominal pain relief,progesterone recovery,hemostasis time and treatment cost under different treatment schemes;The levels of estradiol(E2),progesterone(P),human chorionic gonadotropin(HCG)and progesterone induced blocking factor(PIBF)were compared before and after treatment;Neonatal deformity rate,success rate of fetal protection and neonatal weight were compared;As well as the adverse reactions like dizziness,nausea,breast pain,skin itching were compared.Results The time of lumbar pain relief,abdominal pain relief,progesterone recovery and hemostasis in the observation group were shorter than those in the control group,and the treatment cost was higher than that in the control group(P<0.05).Before treatment,there was no significant difference in E2,P,HCG and PIBF levels between the two groups(P>0.05);After treatment,the levels of E2,P,HCG and PIBF in the two groups were higher than those before treatment,and the levels of various indicators in the observation group were higher than those in the control group(P<0.05).There was no significant difference in neonatal deformity rate and neonatal weight between the two groups(P>0.05);The success rate of fetal protection in the observation group was higher than that in the control group(P>0.05).There was no significant difference in adverse reactions such as dizziness,nausea,breast pain,skin itching between the two groups(P>0.05).Conclusion Dydrogesterone combined with progesterone is effective in the treatment of threatened abortion.It can improve the success rate of fetal protection,promote the recovery of hormone level,and improve the indicators of neonatal birth.It is safe and worthy of clinical application.