哺乳期瘢痕子宫早孕流产方式的临床研究

Abortion ways and announcements of early-staged gestation termination in lactation scarred uterus

目的 探讨哺乳期瘢痕子宫早孕流产方式的选择及注意事项.方法 回顾性分析312例非意愿妊娠要求流产的哺乳期瘢痕子宫患者的临床资料,按其流产方式分为人工流产组（92例）、药物流产组（98例）和米索前列醇联合吸宫术组（联合组,122例）,对三组患者的流产效果、手术时间、术中出血、术后阴道流血时间、术后感染及药物不良反应等进行比较.结果 人工流产组和联合组完全流产率[97.8%（90/92）和99.2%（121/122）]明显高于药物流产组[77.6%（76/98）],术后阴道流血时间[（5.9±1.1）、（5.6±1.2）d]均明显低于药物流产组[（12.4±1.8）d],且术后感染及药物不良反应发生率低,与药物流产组比较差异均有统计学意义（P＜0.05）.联合组与人工流产组比较,手术时间短、术中出血量少、Ⅲ级疼痛发生率低（P＜0.05）.结论 米索前列醇联合吸宫术终止哺乳期瘢痕子宫早孕简化了流产手术步骤,出血少,对母婴影响较小,是一种理想的流产方式.

Objective To estimate abortion ways and announcements of early-staged gestation termination in lactation scarred uterus. Methods A retrospective analysis was made on clinical date of 312 early-staged gestation termination cases in lactation scarred uterus. These cases were divided into three groups based on abortion ways： induced abortion group （group A,92 cases）, drugs abortion group （group B,98 cases）, misoprostol combined uterine aspiration group （group C,122 cases）. The abortive efficiency,operation time, operative bleeding, colporrhagia time, postoperative infection and drug adverse reaction were observed and compared. Results Complete abortion rates in group A （97.8%,90/92） and group C（99.2%,121/122） were significantly higher than that in group B （77.6% ,76/98）,colporrhagia times in group A [（5.9 ± 1.1） d] and group C [（5.6 ± 1.2） d] were significantly lower than that in group B [（12.4 ± 1.8） d],postoperative infection and drug adverse reaction rate were lower in group A and group C, with significant difference compared to group B （P 〈 0.05）. The operation time was shorter, bleeding was less,third-grade pain rate was lower in group C, there was significant difference between group A and group C （P 〈 0.05）.Conclusions Misoprostol combined uterine aspiration terminated early-staged gestation in lactation scarred uterus is effective and safe, makes the operation easy and simple, decreases the blood loss. The influence to mother and infant is smaller, it is the best abortion style.