缩宫素鼻喷雾剂治疗药物流产后出血60例及对月经复潮的影响

Oxytocin Nasal Spray for Treating Hemorrhage after Drug Abortion in 60 Cases and Its Influence on the Menstrual Cycle

目的观察缩宫素鼻喷雾剂治疗药物流产后出血的疗效及对月经复潮的影响。方法选择2013年11月至2014年11月医院收治的早孕并自愿接受药物流产的妇女120例,随机分为对照组和观察组,各60例。对照组患者药流后给予益母草胶囊口服,每次4粒,每日3次;观察组患者在对照组基础上加用缩宫素鼻喷雾剂,两侧鼻腔每次各1喷,每日3次。两组均用药7 d。观察孕囊排出时间及完整程度,阴道出血情况,并于用药后1,2,3周及月经复潮后来院复查,记录药物流产后阴道出血时间、月经恢复时间及不良反应。结果观察组完全流产率为93.33%,明显高于对照组的80.00%(P<0.05)。与对照组相比,观察组药物流产后阴道出血量明显较少,且阴道出血时间明显较短(P<0.05)。观察组月经复潮时间较对照组明显缩短(P<0.05),但月经经期两组相比无明显差异(P>0.05)。随访2个月,观察组月经周期较对照组更规律(P<0.05)。两组患者不良反应发生率相比,差异无显著性(P>0.05)。结论缩宫素鼻喷雾剂可有效增强子宫收缩,降低清宫率,减少阴道流血量,缩短药物流产后阴道出血时间,并能促使月经复潮,规律月经周期。同时鼻腔给药可减少不良反应,值得临床推广。

Objective To observe the efficacy of oxytocin nasal spray in the treatment of bleeding after medical abortion and its influ- ence on the menstrual cycle. Methods 120 cases of early pregnancy and voluntary acceptance of drug abortion women from November 2013 to November 2014 in the hospital were randomly divided into the control group and the observation group,60 cases in each group. The control group was given motherwort capsule （4 capsules/time,3 times/d） orally after drug abortion;on this basis,the obser- vation group was added with oxytocin nasal spray （on both sides of the nasal cavity and 1 spray/time,3 times/d）. Both groups contin- ued medication for 7 d. Gestational sac time, completeness and vaginal bleeding degree were observed; 1,2,3 weeks after treatment, the menstruations were checked at the hospital, and the vaginal bleeding, menstrual recovery time and adverse reactions after drug abortion were recorded. Results After treatment,the complete abortion rate of the observation group was 93.33% ,which was significantly higher than 80.00% of the control group （P 〈 0.05）. Compared with the control group,the amount of vaginal bleeding after drug abortion was significantly fewer in the observation group, and the vaginal bleeding time was significantly shorter （P 〈 0.05）. The time of the observation group was significantly shorter than the control group （P 〈 0.05）,but there was no significant difference in the menstrual cycle between the two groups （P 〉 0. 05）. At 2 months,the menstrual cycle in the observation group was more regular than the control group （P 〈 0.05）. There was no significant difference in the incidence of adverse reactions in the two groups （P 〉 0.05）. Conclusion Oxytocin nasal spray can effectively enhance the contraction of the uterus, reduce the rate of curettage,reduce the amount of vaginal bleeding, shorten the vaginal bleeding time after the drug abortion, and can make menses, regular menstrual cycles. At the same time, nasal administration can reduce the adverse reactions, it is worthy of clinical promotion.