人工流产术后口服优思明与克龄蒙临床疗效比较

Clinical Effects Between Oral Administration of Yasmin and Clement After Induced Abortion

目的比较人工流产术后即时服用屈螺酮炔雌醇片(优思明)、戊酸雌二醇片/雌二醇环丙孕酮片(克龄蒙)对子宫内膜修复的影响。方法将医院2016年1月至2017年12月收治行人工流产术的患者120例随机分为优思明组(39例)、克龄蒙组(39例)和对照组(42例)。3组患者术后3 d均常规口服抗菌药物预防感染及口服产复康颗粒促进子宫复原,优思明组和克龄蒙组患者分别于术后当天开始服用相应药物,对照组患者不服用性激素类药物。结果优思明组及克龄蒙组患者阴道流血时间均明显短于对照组(P <0. 01),前两组无显著差异(P> 0. 05);优思明组患者术后14 d子宫内膜厚度明显小于对照组,克龄蒙组明显大于对照组(P <0. 01);优思明组和克龄蒙组患者月经复潮时间均明显短于对照组(P <0. 05),前两组比较无显著差异(P> 0. 05);观察过程中,3组患者均未发生严重不良反应。结论术后即时周期服用优思明、克龄蒙均可缩短阴道流血时间和首次月经复潮时间,克龄蒙可有效增加子宫内膜厚度,促进子宫内膜修复,但其无避孕作用,不减少再次人工流产率。临床可根据需要合理选用药物。

Objective To compare the effects between immediate administration of Drospirenone Ethinylestradiol Tablets( Yasmin) and Estradiol Valerate Tablets/Estradiol Cyproterone Acetate Tablets( Clement) on endometrial repair after induced abortion. Methods Totally120 patients underwent induced abortion from January 2016 to December 2017 were selected and randomly divided into the Yasmin group( 39 cases),Clement group( 39 cases) and the control group( 42 cases). The patients in the 3 groups received routine oral administration of antibiotics to prevent infection and oral administration of Chanfukang Granules to promote uterine recovery for 3 d after operation. The patients in the Yasmin group and Clement group began to take corresponding drugs on the day after operation,while the patients in the control group did not take hormone drugs. Results The time of vaginal bleeding in Yasmin group and Clement group was significantly shorter than that in the control group( P < 0. 01),but there was no significant difference between the first two groups( P >0. 05). On the 14 th day after operation,the endometrial thickness of Yasmin group was significantly thinner than that of the control group,and that of Clement group was significantly thicker than that of the control group( P < 0. 01). The menstruation recovery time in Yasmin group and Clement group was significantly shorter than that in the control group( P < 0. 05),but there was no significant difference between the first two groups( P > 0. 05). During the observation,no serious adverse reactions occurred in the 3 groups.Conclusion Immediate periodic administration of Yasmin or Clement after induced abortion can shorten the time of vaginal bleeding and the time of the first menstruation recovery. Specifically,Clement can effectively increase the thickness of endometrium and promote the repair of endometrium. However,it has no contraceptive effect and does not reduce the rate of re-induced abortion. It can be reasonably selected according to clinical needs.