药物流产后的B超监测与刮宫时机探讨

SEARCH ON B ULTRASOUND MONITORING AND THE TIME FOR D AND C AFTER ABORTION WITH MIFEPRISTONE

目的：探讨米非司酮药物流产后阴道流血病人是否需要刮宫及刮宫的适宜时机。方法：对药流后眼见有胎物排出的９９例阴道流血病人进行Ｂ超监测，根据Ｂ超显示的宫腔内异常回声团大小及位置进行分组治疗观察，４４例治疗无效行刮宫、病检。结果：回声团≥２０ｍｍ组与＜２０ｍｍ组的刮宫率有明显差异（Ｐ＝０．００００）；回声团的大小与刮宫机率呈正相关（Ｐ＝０．００７９，ｒ＝０．２５１８）；回声团在近宫颈内口处或宫颈管内者无一例刮宫；病检阳性率为９７．６９％。

Objective:To study whether the patients with vaginal bleeding should have uterine dilation and clearance (D and C) after abortion with mifepristone and how to decide on the proper time for the operation Methods:99 cases were monitored with B ultrasound after medicinal abortion who had embryonic sacs elimination but bled too much of too long According to the size and location of the abnormal echo dumpling inside the uterus, the patients were divided into groups for treatment and observation 44 of them had Dand C because they didn't respond to the treatment, and the scraped material was tested pathologically Results:The D and C rate of the group with abnormal echo dumpling ≥20mm was greatly different from that of the group <20mm (P=0 0000);the size of the abnormal echo dumpling in the uterine cavity and the rate of D and C were positively correlated (P=0 0079,r=0 2518) None of the cases had D and C with abnormal echo dumpling near the inner opening of the uterine cervix or inside the cervix The positive rate of pathological tests was 97 69% Conclusion:Utrasound detection is of great, instructive significance to the clinical treatment of patients after medical abortion