孕8～12周终止妊娠后服用屈螺酮炔雌醇避孕效果观察

Observation on contraceptive effect of drospirenone and ethinglestradiol in women of 8～12 gestational weeks after abortion

目的:观察孕8～12周妊娠终止后服用屈螺酮炔雌醇避孕药(商品名:优思明)的疗效。方法:将90例终止妊娠患者分为观察组(60例)和对照组(30例),观察组自胚胎排出清宫术或钳刮术后当晚开始每日睡前服用优思明1片,21天后停药;对照组术后未服用该药,两组患者均于术后14天及月经来潮干净后随访2次,观察术后阴道流血时间、流血量及流产后初次月经恢复情况;观察优思明服用期间的不良反应及患者接受程度等。结果:观察组术后阴道出血时间(6.20±4.40)天,对照组(10.30±6.40)天,两组比较差异有统计学意义(P<0.001);将以往月经量视为1,观察组出血量为(0.48±0.27),对照组为(0.97±0.42),两组比较差异有统计学意义(P<0.001);术后初次月经恢复情况:观察组月经恢复时间可预测,停优思明3～4天后行经,平均(24.50±3.50)天,行经时间(4.70±1.60)天,经量(0.57±0.30);对照组停优思明后平均(33.50±4.50)天行经,行经时间(5.70±1.30)天,经量(1.03±0.32),两组比较差异有统计学意义(P<0.005);服用优思明期间出现不良反应4例,占5.71%,愿意继续使用优思明避孕占14.33%,不愿意者占85.67%。结论:妊娠终止后及时服用优思明可以减少阴道出血量,缩短出血时间,促进月经恢复,可靠避孕,避免重复流产,月经量多者可减少月经量,缓解痛经,不良反应少,但大多数观察者对继续服用激素类药仍不能接受。

Objective：To observe the contraceptive effect of drospirenone and ethinglestradiol （trade name：yasmin） in women of 8 ～ 12 gestational weeks after abortion.Methods：90 women after abortion were divided into observation group （60 cases） and control group （30 cases）.The women in observation group were administered a piece of yasmin every night for 21 days since embryo sac was out,while the control group was administered no drugs.All the cases were followed up on the fourteenth day after operation and finishing menstruation;the duration and volume of postoperative vaginal bleeding and menstrual recovery status were observed;adverse reactions and receiving degree of the patients during treatment were observed.Results：There was significant difference in postoperative vaginal bleeding time between observation group 〔（6.20 ± 4.40） days〕and control group 〔（10.30 ± 6.40） days〕（P 0.001） ;if the normal menstrual volume were 1,there was significant difference in bleeding volume between observation group （0.48 ± 0.27） and control group （0.97 ± 0.42） （P 0.001）.The menstrual recovery status：the menstrual recovery time of observation group could be predicted,menstruation appeared at 3 ～ 4 days after stopping yasmin,（24.50 ± 3.50） days on average,the duration time of menstruation was （4.70 ± 1.60） days,the menstrual volume was （0.57 ± 0.30） ;after stopping yasmin,menstruation appeared at （33.50 ± 4.50） days on average,the duration time of menstruation was （5.70 ± 1.30） days,the menstrual volume was （1.03 ± 0.32）,there was significant difference （P 0.005） ;adverse reactions occurred in 4 cases during taking yasmin,accounting for 5.71% ;14.33% of the cases wanted to take yasmin for contraception,85.67% of the cases didn＇t want to take yasmin.Conclusion：Timely intake of yasmin after abortion may reduce the volume of vaginal bleeding,shorten the time of vaginal bleeding,promote the recovery of menstruation,contracept effectively,avoid repeated abortion,regulate menstruation,relieve menorrhalgia with less adverse reaction,but most of the cases can＇t content to take hormonal medicine long term.