药物流产联合负压吸宫术终止哺乳期妊娠临床研究

Clinical Studies of Medical Abortion Associated with Artificial Abortion on Terminating Lactational Pregnancy

目的探讨药物流产联合负压吸宫术对哺乳期妊娠流产的有效性及安全性。方法对160例哺乳期早期妊娠患者流产方式进行前瞻性研究。结果负压吸宫人工流产组(传统组):完全流产率为90.00%,术中出血(33.75±15.21)mL,术后阴道流血(8.14±5.16)d,人工流产综合反应发生率11.25%,宫颈粘连发生率10.00%,术后感染率11.25%,子宫穿孔发生率7.50%;药物流产联合负压吸宫术组(联合组):分别为100.00%,(20.38±9.20)mL,(5.05±2.27)d,2.50%,3.75%,8.75%,无子宫穿孔发生。两组患者完全流产率、术中出血量、术后阴道流血时间相比较,差异有显著性意义(P<0.05)。并发症方面,两组患者人工流产综合反应发生率、宫颈粘连发生率、子宫穿孔发生率相比差异有显著性意义(P<0.05),而术后感染率相近。结论药物流产联合负压吸宫术终止哺乳期早孕,完全流产率高,术中出血少,术后阴道流血时间短,人工流产综合反应、宫颈粘连、子宫穿孔发生率均低,不增加术后感染率。

Objective To explore the best abortion methods in lactation. Methods Abortion methods of 160 cases with pregnant women within lactation were researched prospectivly. Results The complete abortion rate was 90.00% in artificial abortion group （tradition group）while 100.00% in medical abortion associated with artificial abortion group （association group）;the amount of bleeding during operation was （33.75± 15.21）mL in tradition group while （20.38±9.20）mL in association group, the time of vagina bleeding was（8.14±5.16）days in tradition group while （5.05±2.27）days in association group. In tradition group, the reaction rate of artificial abortion syndrome was 11.25%, the cervix uteri adhesion rate was 10.00%,the postoperative pelvic infection rate was 11.25%,the uterine perforation rate was 7.50%; In association group, the reaction rate of artificial abortion syndrome was 2.50%, the cervix uteri adhesions rate was 3.75%, the postoperative pelvic infection rate was 8.75% and no uterine perforation occurred. Conclusion Medical abortion associated with artificial abortion have higher rate of complete abortion than artificial abortion, it is helpful to decrease the amount of bleeding during operation, shorten the time of vagina bleeding and decrease complication.