人工流产术后药物干预对子宫内膜影响的临床观察

Clinic Observation of Medicine Influence to Endometrium after Induced Abortion

目的:评价在人工流产术后口服短效避孕药优思明及单纯雌激素补佳乐对减少术后阴道流血时间、促进术后子宫内膜恢复、缩短首次月经恢复时间及减少术后并发症的临床疗效。方法:选择来我院因非意愿妊娠者要求行无痛人工流产者为研究对象,随机分为对照组即未用药组(n=200),优思明组(n=100)和补佳乐组(n=100)。3组均于术后2周及月经转归后1个月、3个月后随诊。观察术后阴道流血时间、术后2周子宫内膜厚度、首次月经恢复时间及术后3个月内并发症的发生情况。结果:①优思明组术后阴道流血时间短于对照组和补佳乐组,差异均有统计学意义(P<0.05);②优思明组术后2周子宫内膜略厚于对照组,但差异无统计学意义(P>0.05),补佳乐组术后2周子宫内膜厚度大于对照组和优思明组,差异有统计学意义(P<0.05)。③优思明组术后首次月经恢复时间短于对照组和补佳乐组,差异有统计学意义(P<0.05)。④用药组(优思明组和补佳乐组)术后并发症发生率均低于对照组,差异有统计学意义(P<0.05);用药组宫腔积液发生率低于对照组,差异有统计学意义(P<0.05)。结论:人工流产术后立即服用单纯雌激素对子宫内膜厚度的恢复优于避孕药,术后并发症的发生率更低。

Objective： To access the clinical curative effect of reducing bleeding period of vagina, accelerating endometrium recovery, shortening recovery time of first menstrual cycle and reducing the incidence of postoperative complications by taking Yasmin and Progynova after induced abortion. Methods： The cases who received the painless abortion were selected and divided into three groups randomly： control group （without medicines, n=200）, Yasmin group （n=100） and Progynova group （n=100）. All cases were observed at the following time： 2 weeks after operation, the first menstrual cycle and the third emmenia cycle. The vagina bleeding period, the thickness of endometrium at 2 weeks after operation, the first emmenia recovery time and the incidence of postoperative com- plications within three months after abortion were observed. Results：l） Vagina bleeding period of Yasmin group was shorter than other two groups, with statistical significance （P〈0.05）. 2） The thickness of endometrium of Yasmin group at 2 weeks after abortion was thicker than the control, but with no statistical significance （P〉0.05）.The thickness of endometrium of Progynova group at 2 weeks after abortion was thicker than the control and Yasmin group, with statistical significance （P〈0.05）. 3） The first recovery time of menstrual cycle after operation of Yasmin was significantly shorter than that of the control and Progynova group （P〈0.05）. 4） The incidence of postoperative complications of observation group （Yasmin group and Progynova group） was significantly lower than the control （P〈0.05）. The incidence fluid in cavitary uteri of observation group was lower than the control group, with statistical significance （P〈0.05）. Conclusion： Taking orally the estrogen immediately after the abortion is better for endometrium recovery and reducing the incidence of postoperative complications than taking the contraceptive pills.