不同疗程的hCG联合黄体酮治疗先兆流产的研究

Different courses of human chorionic gonadotrophin therapy combined with l^ro^esterone in treatment of threatened abortion

目的对比观察不同疗程的人绒毛膜促性腺激素（hCG）联合黄体酮治疗早期先兆流产的临床疗效及安全性。方法将2008年6月至2011年7月在海南省农垦总医院妇产科就诊的180例孕周〈6周首次妊娠出现阴道流血伴腰酸腹坠症状的先兆流产患者随机分为A（治疗2周）、B（治疗4周）、C（治疗7周）不同疗程的3个组，每组60例，均给予hCG联合黄体酮治疗。比较3组的阴道流血缓解率、腰酸腹坠缓解率、流产治愈率及不良反应发生率。结果接受治疗后，C组和B组的阴道流血缓解率均为100．00％，明显高于A组的71．67％（肌2A=4．15，肌2A=3．51，均P〈0．05）；C组和B组的腰酸腹坠缓解率分别为98．33％和90．00％，明显高于A组的66．67％（X2CA=3．82、X2BA：3．66，均P〈0．05）；C组的流产治愈率为93．33％明显高于B组的78．33％和A组的63．33％，3组流产治愈率两两比较后，差异均有统计学意义（X22CA=3．89、疋2BA=2．88、X2BC=4．32，均P〈0．05）；3组的不良反应率比较无明显差异（P〉0．05）。结论7周疗程的hCG联合黄体酮治疗早期先兆流产能显著改善患者的阴道流血及腰酸腹坠情况，降低胎儿流产率，值得，临床推广。

Objective To compare the efficacy and safety of different courses of human chorionic gonadotrophin （hCG） therapy combined with progesterone for treating early threatened abortion. Methods From June 2008 to July 2011 there were 180 cases of threatened abortion diagnosed in Hainan Agricultural Reclamation General Hospital, whose gestational age was less than 6 weeks with first pregnancy and symptoms of vaginal bleeding and backache. They were randomly divided into group A （ treatment for 2 weeks）, group B （ treatment for 4 weeks） and group C （treatment for 7 weeks） according to courses of therapy. There were 60 cases in each group, and all of them were treated with hCG and progesterone. The remission rates of vaginal bleeding and waist soreness and stomach dropping, curing rate of abortion, and incidence of adverse reactions were compared among three groups. Results After treatment, the remission rate of vaginal bleeding both in group C and group B was 100.00% which was significantly higher than that of group A （71.67%） （X2CA =4.15 2 XBA =3.51, both P 〈0.05）. The remission rates of waist soreness and stomach dropping in group C and group B were 98.33% and 90.00% , respectively, and they were significantly higher than that of group A （66.67%） （X2CA = 3.82, X2SA = 3. 66, both P 〈 0.05）. The curing rate of abortion in group C was 93.33% , and it was significantly higher than 78.33% of group B and 63.33% of group A. There were significant differences in curing rate of abortion in multiple comparison （X2CA= 3. 89, XBA2 = 2. 88, X8c2 = 4.32, all P 〈 0.05 ）. But the incidence of adverse reactions was not significantly different among three groups （ all P 〉 0.05 ）. Conclusion Seven weeks therapy of hCG combined with progesterone can obviously relieve the symptoms of vaginal bleeding and waist soreness and stomach dropping in early threatened abortion. It can reduce miscarriage rate and it is worthy of popularizing.