透明质酸钠宫腔注入及优思明口服对稽留流产患者术后宫腔粘连的预防效果

Effects of intrauterine injection of sodium hyaluronate and oral administration of Yasmin on intrauterine adhesions after missed abortion surgery

目的观察透明质酸钠宫腔注入及优思明口服减轻稽留流产患者术后宫腔粘连的效果及安全性。方法将800例因稽留流产而行清宫手术的患者按随机数字表法分为实验A、B、C组及对照组各200例,四组均由同一组高年资主治医师严格按照操作规则进行全程超导可视无痛清宫术(术前用药均为复方米非司酮及米索前列醇),其中实验B组术毕宫腔注入透明质酸钠1 mL,实验C组术后即刻开始口服优思明1片/d,连续21 d,实验A组同时应用上述两种方法。观察各组手术情况、月经量变化及宫腔粘连发生情况、药物不良反应。结果各组均未发生术中并发症,手术时间无显著差异;各实验组月经量减少及宫腔粘连发生率均低于对照组,尤以实验A组为著(P均<0.05)。实验A组和C组各有1例出现轻微头晕、恶心、乳房胀痛及术后阴道流血、月经间期阴道点滴出血等,均自行好转;无体质量增加者。结论透明质酸钠宫腔注入联合优思明口服可显著降低稽留流产患者术后宫腔粘连发生率,且安全性高。

Objective To observe the effects and safety of using intrauterine injection of sodium hyaluronate and oral administration of Yasmin to alleviate intrauterine adhesions after missed abortion surgery .Methods Totally 800 patients with missed abortion undergoing curettage surgery were randomly divided into the experimental A , B, C groups and the con-trol group of 200 cases.Four groups were all given the entire superconducting visual painless curettage surgeries by the same group of high qualification physician in strict accordance with the operating rules （ premedication was compound mife-pristone and misoprostol）.After the surgery, patients in the experimental group B were injected sodium hyaluronate 1 mL;patients in the experimental group C immediately took Yasmin 1 pill/d orally for 21 days.Patients in the experimental group A applied the above two methods at the same time .The surgery, the changes of menstrual flow , the incidence of intrauter-ine adhesions and adverse drug reactions of each group were observed .Results The intraoperative complications did not occur in each group and there was no significant difference in the operative time .The incidences of menstrual flow reduction and intrauterine adhesions in the experimental groups were lower than those of the control group , especially in the experi-mental group A （all P〈0.05）.Patients in the experimental group A and group C got the mild individual dizziness , nause-a, breast tenderness and postoperative vaginal bleeding , vaginal spotting between periods , but they all made self-improve-ment.Those groups didn′t get the weight gain.Conclusion The intrauterine injection of sodium hyaluronate combined with the oral administration of Yasmin can significantly alleviate the incidence of intrauterine adhesions after missed abortion surgery with high safety .