早早孕负压吸引人工流产术的临床分析

Clinical analysis of vacuum-aspiration induced abortion of early-early pregnancy

目的观察早早孕负压吸引人工流产术（早早孕吸宫术）的临床效果。方法收集5742例接受早早孕（停经≤42d，孕囊三径均值≤10mm）吸宫术（早早孕组）与2935例接受常规（停经43～50d，孕囊三径均值〉10mm）负压吸引人工流产术（常规组）患者的临床资料，并进一步将早早孕组分为停经≤36d（n=902）和停经37～42d（17,=4840）两亚组，对术中出血量、吸出组织量、手术时间、手术并发症（人工流产综合征、子宫穿孔）发生率及流产结局进行分析和比较。结果与常规组比较，早早孕组术中出血量和吸出组织量更少（P〈0．0001），手术时间较短（P〈0．01）；早早孕组人工流产综合征和子宫穿孔的发生率显著低于常规组（P〈0．05，P〈0．001）；两组流产结局比较差异无统计学意义（P〉0．05）。与停经37～42d组比较，停经≤36d组术中出血量和吸出组织量更少（P〈0．0001），手术时间更短（P〈0．01）。结论与常规负压吸引人工流产术比较，早早孕吸宫术具有术中出血少、吸出组织量少、手术时间短的优点，且停经36d内行早早孕吸宫术其优越性更为明显。

Objective To observe the clinical effects of vacuum-aspiration induced abortion of early-early pregnancy. Methods Clinical data of 5 742 women （the early-early pregnancy group） who underwent vacuum-aspiration induced abortion of early-early pregnancy （ amenorrhea ≤42 d and the mean diameter of the gestation sac diameters ≤ 10 mm） and 2 935 women （the routine group） who underwent vacuum-aspiration induced abortion （amenorrhea for 43 -50 d and the mean diameter of the gestation sac diameters 〉 10 mm） were collected. The early-early pregnancy group was further divided into two subgroups, i.e. amenorrhea≤36 d group （n=902） and amenorrhea =37 --42 d group （n =4 840）. The amount of bleeding during induced abortion, amount of aspirated abortus, aspirating time, incidence of complications （ induced abortion syndrome and perforation of uterus）, and outcomes of induced abortion were analyzed and compared. Results The amount of bleeding and aspirated abortus （P〈0. 000 1） and the operating time （P〈0. 01） of the early-early pregnancy group were significantly less than those of the routine group. The incidence of induced abordon syndrome （P〈0. 05） and perforation of uterus （P〈0. 001） of the early-early pregnancy group was significantly lower than that of the routine group. The differences of outcomes of induced abortion of two groups were not statistically significant （ P 〉 0.05）. The amount of bleeding and aspirated abortus （ P 〈 0. 000 1 ） and the operating time （P〈0. 01） of the amenorrhea≤36 d group were less than those of the amenorrhea =37 -42 d group. Conclusion Compared to the routine vacuum-aspiration, the advantages of vacuum aspiration of early-early pregnancy are less bleeding, less amount of aspirated abortus, and shorter operating time. For woman with amenorrhea≤36 d, the advantages of vacuum-aspiration induced abortion are more significant.