口服雌孕激素对稽留流产患者宫腔镜下清宫术后性激素水平及粘连发生情况的影响

Effects of Oral Estrogen-progesterone on the Levels of Sex Hormones and the Adhesion Occurrence after Hysteroscopic Curettage in Patients with Missed Abortion

目的:探究口服雌孕激素对稽留流产患者宫腔镜下清宫术后性激素水平及粘连发生情况的影响。方法:选取2017年6月-2019年9月本院90例行宫腔镜下清宫术稽留流产患者,按随机数字表法分为对照组与观察组,每组45例。对照组术后给予常规治疗,观察组在对照组基础上给予口服雌孕激素治疗。比较两组粘连发生率、治疗前后性激素水平、子宫内膜血流参数及粘连指标。结果:观察组粘连发生率明显低于对照组(P<0.05)。治疗1、2周后,观察组雌二醇(E2)均高于对照组,而孕酮(P)及促黄体生成素(LH)均低于对照组,差异均有统计学意义(P<0.05)。治疗1、2周后,观察组转化生长因子-β(TGF-β)及血小板源性生长因子(PDGF)均低于对照组,差异均有统计学意义(P<0.05)。治疗1、2周后,观察组血管化指数(VI)及血流指数(FI)均高于对照组,差异均有统计学意义(P<0.05)。结论:口服雌孕激素可有效改善稽留流产患者宫腔镜下清宫术后性激素水平,减少粘连发生,改善子宫内膜血流,具有较高临床应用价值。

Objective:To investigate the influence of oral estrogen-progestogen on the level of sex hormone and the adhesion occurrence after hysteroscopic curettage in patients with missed abortion.Method:From June 2017 to September 2019,90 patients with missed abortion underwent hysteroscopic curettage in our hospital were selected.According to the random number table method,they were divided into control group and observation group,45 cases in each group.The control group was treated with routine treatment after surgery,and the observation group was treated with oral estrogen-progestogen on the basis of the control group.The incidence of adhesion,sex hormone levels,endometrial blood flow parameters and adhesion indexes before and after treatment were compared between the two groups.Result:The incidence of adhesion in the observation group was significantly lower than that in the control group,the differences were statistically significant(P<0.05).1 and 2 weeks after treatment,estradiol(E2)in the observation group were higher than those in the control group,while progesterone(P)and luteinizing hormone(LH)were lower than those in the control group,the differences were statistically significant(P<0.05).1 and 2 weeks after treatment,transforming growth factor-β(TGF-β)and platelet-derived growth factor(PDGF)in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).1 and 2 weeks after treatment,vascularization index(VI)and blood flow index(FI)in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).Conclusion:Oral estrogen-progestogen can effectively improve the level of sex hormone after hysteroscopic curettage in patients with missed abortion,reduce the incidence of adhesion,and improve the endometrial blood flow,which has high clinical application value.