黄体酮个体化治疗复发性流产的临床研究

Clinical research for the individualized treatment of recurrent spontaneous abortion by progesterone

目的探讨黄体酮个体化治疗复发性流产的临床疗效。方法回顾性分析本院就诊的60例复发性流产患者的临床资料,根据治疗方法将其分为试验组与对照组,每组各30例,对照组每日常规剂量肌肉注射黄体酮,试验组患者根据每周检查孕酮值调整黄体酮用量。比较分析两组患者治疗至孕12周黄体酮用量、注射天数及两组患者的平均分娩孕周、流产率、早产率、围生儿不良结局(死亡和患病)发生率。结果试验组患者黄体酮总用量(1456.23±206.36)mg与注射天数(36.23±6.54)d明显少于对照组(1827.48±242.05)mg,(43.54±3.63)d,两组差异有统计学意义(P<0.05),且试验组平均分娩孕周、流产率、早产率及围生儿不良结局(死亡和患病)发生率均少于对照组,差异有统计学意义(P<0.05)。结论黄体酮个性化调整剂量可提高复发性流产患者保胎成功率,并减少了用量,降低了围生儿不良结局,更适合临床应用。

Objective To investigate the clinical effect of the individualized treatment of recurrent spontaneous abortion by progesterone. Methods The clinical data of 60 cases of patients with recurrent spontaneous abortion were retrospectively analyzed, and according to the treatment methods, divided into the experimental group and control group, 30 cases in each group. The control group was given conventional dose progesterone injection. According to the weekly inspection progesterone, patients in the experimental group were adjusted the dosage of progesterone. The pregnancy of 12 weeks, the number of days of injection dosage of progesterone and the mean gestational age at delivery, abortion, premature delivery, perinatal adverse outcomes （death and disease incidence rate） between two groups were compared. Results The total amount progesterone of the test group （1456.23±206.36）mg, and （36.23±6.54） days of the injection of days significantly less than the control group （1827.48±242.05） mg,（43.54±3.63）d. The differences between the two groups were statistically significant （P 〈 0.05）. The average gestational age at delivery, abortion, premature delivery rate and adverse perinatal outcome （mortality and morbidity） incidence of experimental group was less than that of the control group, the difference was statistically significant （P 〈 0.05）. Conclusion Progesterone personalized dose adjustment can improve the success rate of patients with recurrent spontaneous abortion, and reduce the dosage and the adverse perinatal outcome. It is more suitable for clinical application.