雌孕激素序贯疗法在稽留流产行刮宫术后患者中的应用价值

Application value of sequential therapy of estrogen and progesterone in patients with missed abortion after curettage

目的探讨雌孕激素序贯疗法在稽留流产行刮宫术后患者中的应用价值。方法采用随机数字表法将本院2016年9月至2018年9月接收的150例稽留流产行刮宫术孕妇分为对照组(n=75)和研究组(n=75)。对照组术后给予常规治疗,研究组在对照组的基础上给予雌孕激素序贯疗法。比较两组孕妇术后恢复情况、治疗前、后性激素水平、宫腔粘连情况及其他并发症发生情况。结果研究组术后月经恢复时间短于对照组,子宫内膜厚度大于对照组,差异具有统计学意义(P<0.05)。治疗前,两组FSH、E2、P水平比较,差异无统计学意义(P>0.05);治疗后,两组FSH、E2水平均高于治疗前,P水平均低于治疗前,且研究组优于对照组,差异具有统计学意义(P<0.05)。研究组宫腔粘连发生率为2.67%,低于对照组的12.00%,差异具有统计学意义(P<0.05)。研究组闭经和流产不全总发生率低于对照组,差异具有统计学意义(P<0.05)。结论稽留流产孕妇刮宫术后采用雌孕激素序贯疗法治疗可促进子宫内膜修复,调节性激素水平,预防相关并发症。

Objective To explore the application value of sequential therapy of estrogen and progesterone in patients with missed abortion after curettage. Methods One hundred and fifty pregnant women with missed abortion undergoing curettage admitted in our hospital from September 2016 to September 2018 were divided into control group (n=75) and study group (n=75) according to the random number table method. The control group were given routine treatment after operation, while the study group were given sequential therapy of estrogen and progesterone on the basis of the control group. The recovery of pregnant women after operation, sex hormone levels before and after treatment, intrauterine adhesions and other complications were compared between the two groups. Results The time of menstruation recovery after operation in the study group was shorter than that in the control group, and the thickness of endometrium was larger than that in the control group, and the differences were statistically significant (P<0.05). Before treatment, there were no significant differences in the levels of FSH, E2 and P between the two groups (P>0.05);after treatment, the levels of FSH and E2 in the two groups were higher than those before treatment, and the level of P was lower than that before treatment, those of the study group were better than the control group, and the differences were statistically significant (P<0.05). The incidence of intrauterine adhesions in the study group was 2.67%, which was lower than 12.00% in the control group, and the difference was statistically significant (P<0.05). The total incidence of amenorrhea and incomplete abortion in the study group was lower than that in the control group, and the difference was statistically significant (P<0.05). Conclusion The sequential therapy of estrogen and progesterone in patients with missed abortion after curettage can promote endometrial repair, regulate the level of sex hormones and prevent related complications.