雌孕激素序贯疗法在稽留流产刮宫术后的临床应用研究

Sequential application of estrogen and progesterone in therapy of missed abortion after dilation and curettage

目的：观察雌孕激素序贯疗法用于稽留流产刮宫术后的临床效果.方法：选择2010年1月～2011年6月入住本院的稽留流产患者300例,根据受术者意愿分为观察组和对照组.观察组刮宫术后第5天口服戊酸雌二醇（补佳乐）1mg,每日1次,共21d,后10d加服黄体酮胶囊100mg,每日2次,以后每次月经后第5天开始,共用3个周期.对照组刮宫术后未用雌孕激素治疗.结果：观察组首次月经恢复时间及术后子宫内膜修复情况均优于对照组（P＜0.01）,月经量减少、宫腔粘连发生率低于对照组（P＜0.01）.结论：稽留流产妇女刮宫术后进行雌孕激素序贯治疗有利于子宫内膜修复及恢复正常月经周期,预防宫腔粘连,值得临床应用.

Objective：To evaluate the feasibility,safety and prognosis of sequential application of estrogen and progesterone in therapy of missed abortion after dilation and curettage.Methods：Thirty hundred women with missed abortion who had performed dilation and curettage in Maternal and Child Health Care Hospital of Jinhua between January 2010 and June 2011 were divided into two groups.Women in the study group received oral intake of ling of estradiol valerate per day for 21 days on the fifth day after dilation and curettage,and 100mg of progesterone capsules two times per day in last 10 days of estrogen intake.And the next two treatment cycles were both started from the fifth day after blood withdrawal.There was no hormone therapy after dilation and curettage in the control group.Results：Women in the study group had shorter menstruation recover period and better endometrial repair（P ＜ 0.01）.And the incidence of reduced menstrual flow and intrauterine adhesion of the study group were both significantly lower than those of the control（P ＜0.01）.Conclusion：The sequential therapy of estrogen and progesterone after curettage was benefit for women experiencing missed abortion in endometrial repair,recover of menstruation cycle,prevention of instrauterine adhesion and amenorrhea,and the method is worthy of clinical application.