药物流产后阴道持续流血的临床观察与治疗探讨

The Clinical Observations and Investigations About the Continuous Bloodshed after Medical Abortion

目的:探讨药物流产后阴道持续流血的临床治疗以及治疗方法。方法:选取本院收治药物终止妊娠患者64例,将患者按照随机数字表法分为观察组和对照组,每组32例。对照组前2天服用米非司酮,晨空腹服用50 mg,晚空腹服用25 mg,在服药前后2 h不进食。第3天上午实施阴道后穹隆置入米索前列醇600μg,观察组除以上操作外还进行清宫术。结果:观察组平均出血时间为(13.2±1.5)d,对照组为(19.3±3.8)d;观察组平均出血量为(56.3±4.5)mL,对照组为(96.0±5.7)mL;观察组月经复潮时间为(32.3±5.2)d,对照组为(43.4±10.2)d;两组比较差异均有统计学意义(P<0.05)。观察组尿hCG转阴时间超过14 d的发生率为21.9%,对照组为53.1%;观察组术后炎性细胞浸润率为28.1%,对照组为71.9%,两组比较差异均有统计学意义(P<0.05)。结论:药物流产后如果持续流血时间过长需进行清宫术,以利于康复和减少并发症。

Objective：To explore the clinical observations and investigations about the continuous bloodshed after medical abortion.Method：Sixty-four patients of our hospital who were aborted by drug were randomly divided into the observation group and the control group,each group of 32 cases.Each patient of the control group took mifepristone with fasting in the first two days,50 mg in the morning,25 mg in the evening,and was placed misoprostol through vagina in the third morning.In addition,the observation group also applied curettage.Result：Bleeding time of the observation group was（13.2±1.5）days,and the control group was（19.3±3.8）days;The average bleeding amount of the observation group was（56.3±4.5）mL,and the control group was（96.0±5.7）mL,The menstruation restoration time of the observation group was（32.3±5.2）days,and the control group was（43.4±10.2）days,and the differences between the two groups were all statistically significant（P〈0.05）.The probability of surpassing 14 days which was the time of overcast of urine hCG of the observation group was 23.8%,and the control group was 53.4%;The inflammatory cells invasion rate of the observation group was 28.1% while the control group was 71.9% after treatment,and the differences between the two groups were all statistically significant（P〈0.05）.Conclusion：It is essential to operate curettage for the continuing bloodshed after medical abortion,for the sake of better rehabilitation and less complications