药物流产后子宫异常出血原因分析及药物刮宫疗效观察

Analysis of Causes of Abnormal Uterine Bleeding after Medical Abortion and the Effect of Drug Curettage on It

目的探讨药物流产后子宫异常出血原因,寻找药物流产后弥补措施。方法将2000年1月～2005年1月来我院药物流产发生异常子宫出血病例分别进行了B超、刮宫跟踪观察,分析原因。对2005年2月～2006年6月来我院药物流产发生异常子宫出血病例采取药物性刮宫措施,弥补药物流产的不足。结果单纯胎盘残留59.58%,单纯滤泡囊肿22.92%,二者并存15%,无异常发现12.5%.用药后流血停止时间2～5d,平均4±0.8d。均于停药2～6d月经来潮,量及持续时间基本同于正常月经,月经干净后行B超检查,原有残留者宫内异常回声95%消失,原有囊肿者,囊肿85%消失。结论造成药物流产后异常子宫出血的原因主要是组织残留,其次是卵巢滤泡囊肿的存在。药物性刮宫可以治疗药流后异常子宫出血,弥补药流不足。

Objective To investigate the causes and remedial measures of abnormal uterine bleeding after medical abortion. Methods Patients who suffered from abnormal uterine bleeding after medical abortion between January 2000 and January 2005 were followed up by means of ultrasonography and curettage, the causes were analyzed. Patients between February 2005 and July 2006 with abnormal uterine bleeding after medical abortion were taken medical curettage to make up the short of medical abortion. Results 59.58 % of cases suffered from retained placental tissue, 22.92 % of cases suffered from follicular cyst, retained placental tissue and follicular cyst coexisted in 15 % of cases, and 12.5 % of cases had no abnormal findings. The time of bleeding stop was 2 - 5 days after use of medicine, average 4 ± 0.8 days. Menstruation occurred 2 - 6 days after stoping use of medicine in all patients, the loss and duration time is basically the same as normal menstruation. Ultrasonography was taken after menstruation, abnormal echogenic material disappeared in 95 % of patients with retained placental tissue, and the cyst disappeared in 85 % of patients with follicular cyst. Conclusions The main cause of abnormal uterine bleeding after medical abortion is retained placental tissues, the second is ovarian follicular cyst. Medical curettage can be used to treat abnormal uterine bleeding after medical abortion.