黄体酮治疗早期流产的疗效及对围生儿结局的影响

Effect of progesterone in the treatment of early abortion and its influence on the outcome of perinatal infants

目的对比黄体酮两种给药方式治疗早期流产的临床疗效及外源性补充黄体酮对围生儿结局的影响。方法选取于妇产科接受治疗的174例早期流产患者为研究对象,按随机数字法分为口服组和肌注组,各87例,治疗有效的围生儿设为观察组,选择同期于行孕期检查的无早期流产症状的87例健康孕妇的围生儿设为对照组,比较口服组与肌注组患者的临床治疗总有效率及治疗前后孕酮变化,比较观察组与对照组围生儿的低体重出生率、早产率、新生儿畸形率、Apgar评分低分儿率及新生儿病死率。结果口服组患者临床治疗总有效率为90.80%,肌注组为93.10%,差异无统计学意义(P>0.05)。两组患者治疗后孕酮水平均显著高于治疗前(P<0.01)。两组患者治疗前、治疗后孕酮水平的组间比较差异均无统计学意义(P>0.05)。观察组、对照组围生儿妊娠结局差异无统计学意义(P>0.05)。结论无论是口服给药还是肌注给药,外源性补充黄体酮制剂均可获得较好的临床疗效,对围生儿健康无明显不良影响,且两种给药方式疗效相当,临床医生可结合患者病情、病人个人意愿及实际应用情况选择合适的给药途径。

Objective To compare effects of progesterone on early abortion treated by two administration methods and study the influence of supplement of exogenous progesterone on outcome of perinatal infants.Methods 174 pa-tients with early spontaneous abortion and being treated in the Department of Obstetrics and Gynecology of our hospi- tal were selected as the study object.They were randomly divided into the oral group and the intramuscular injection group with 87 cases in each group.Perinatal infants with effective treatment were selected as the observation group, while 87 perinatal infants of healthy pregnant women without early abortion symptoms during pregnancy test in the same period were selected as the control group.Then, the total effective treatment rate and progesterone changes of the oral group and the intramuscular injection group were compared before and after treatment. The low birth weight rates, preterm delivery rates, neonatal congenital malformation rates, low Apgar score rates and neonatal mortality rates of perinatal infants in the observation group and the control group were also compared.Results The total effec-tive treatment rate of the oral group was 90.80 % and that of the intramuscular injection group was 93.10%, so the difference was not statistically significant（ P 〉0.05）. After treatment,the progesterone levels of the two above-men- tioned groups were significantly higher than those before treatment（ P 〈0.01）,and there was no statistical signifi-cance in the difference of progesterone levels between two groups before and after treatment（ P 〉0. 05）.In addition, there was no statistical significance in the difference of pregnancy outcomes of perinatal infants in the observation group and the control group（ P 〉0.05）.Conclusion Both oral or intramuscular administration of exogenous proges-terone as supplement can obtain positive clinical curative effect with no obvious adverse effect on the health of perina-tal infants. Meanwhile, the two administration methods have equivalent efficacy, so clinicians should choose proper methods of supplementing progesterone according to patients＇ conditions and willingness as well as practical applica-tion.