人流致子宫穿孔的相关因素分析

The relative factors and treatments on 116 cases of uterine perforation by artificial abortion operation

目的:探讨人流致子宫穿孔的相关因素及其处理。方法:对我院116例人流致子宫穿孔患者进行回顾性分析。结果:总的人流致子宫穿孔的发生率为2.915‰(116／39 796)。其中,子宫位置异常、畸形,多次妊娠史,哺乳期子宫,疤痕子宫等为行人流术致子宫穿孔的高危因素。器械致子宫穿孔发生率:探针及吸管的发生率最高(1.263‰及1.713‰)。子宫穿孔的处理,85例用米非司酮加米索方案,成功率为90.588％(77／85),其余有残留者B超下行清宫术。结论:人流致子宫穿孔与子宫位置异常、畸形、多次妊娠史、哺乳期子宫、疤痕子宫等有明显关系;人流过程中用探针及吸管时要特别注意。子宫穿孔后用米非司酮加米索治疗是行之有效的方法。

Objective: To investigate related factors and suitable treatments of uterine perforation by artificial abortion operation. Methods: This retrospective study has being carried out with 116 cases of uterine perforation by artificial abortion operation in this hospital. Results: The total rate of uterine perforation by artificial abortion operation is 2. 915% (116/39 796). With uterus in abnormal position, congenital defects of the uterus, multi-pregnancy history, during lactation uterus, or scar uterus, the rates of uterine perforation are 19. 98‰,19. 48‰,8. 414‰,9. 488‰,and 16. 618‰ respectively, and are significantly higher than the total rate. Compared with other medical equipment, the rates of uterine perforation caused by uterine sound and aspiration tube are the highest: 1.237‰ and 1. 685‰. To deal with the uterine perforation, mifepristone and misoprostol has been used in 85 cases, rate of success is 90. 59%. The rest accepted curettage with the help of the B-mode Ultrasound. Conclusion: Uterine perforation by artificial abortion operation is statistically associated with uterus in abnormal position, congenital defects of the uterus, multi-pregnancy history, during lactation uterus, or scar uterus. During artificial abortion operations, more attention should be paid to the uterine sound and the aspiration tube. After uterine perforation the treatment schedule of mifepristone combined with misoprotol is safe and effective.