不完全流产的三种治疗方式临床观察

The curative observation of three methods in treating incomplete abortion

目的比较药物、清宫及宫腔镜下组织取出三种不同方法治疗不全流产的临床疗效。方法选取本院2014年1月至2017年9月收治的不全流产患者261例,其中药物治疗104例,清宫术治疗84例,宫腔镜下组织取出73例,对照观察不同治疗方式的成功率、阴道出血时间、生殖器感染率、术后月经改变情况并进行比较分析。结果清宫组及宫腔镜治疗组治愈率显著高于药物治疗组(P<0.05),阴道出血时间显著低于药物治疗组(P<0.05)。药物治疗组及宫腔镜治疗组生殖器感染率及术后月经改变比例显著低于清宫组(P<0.05)。结论针对不全流产患者的不同情况,可酌情选择药物治疗、清宫治疗以及宫腔镜下组织取出等方法进行治疗,在除外禁忌证后宫腔镜治疗在生殖保护及并发症预防方面存在明显优势,并可作为其他治疗失败后的首选补救措施。

Objective To compare the clinical efficacy of different methods in treating incomplete abortion. Method An investigation was held with 261 cases reviewed during from Jan.2014 to Sep.2017 in our hospital. All the cases were divided into 3 groups by different method such as medication（Group A,104 cases）, complete curettage of uterine cavity（Group B,84 cases） and hysteroscopy operation（Group C,73 cases）. Achievement ratio, vaginal bleeding time, infection rate of pelvic cavity, and incidence rate of menstrual changes were assessed. Result The achievement ratio in Group B and Group C are higher than in Group A significantly（P〈0.05）. The vaginal bleeding time in Group B and C are shorter than in Group A significantly（P〈0.05）. The incidence rate of menstrual changes in Group A and C are lower than in Group B（P〈0.05）. Conclusion Medication, complete curettage of uterine cavity and hysteroscopy operation can be selected to deal with incomplete abortion according to different situation of patients. Aside from contraindications, hysteroscopy operation is better than both the other two sorts of methods in reproductive protection and prevention of complication and should be preferred to deal with incomplete abortion especially after treatment failure by other methods.