多次人工流产者术后戊酸雌二醇联合安宫黄体酮序贯治疗对子宫恢复效果

Effect of sequential treatment of estradiol valerate combined with medroxyprogesterone on postoperative recovery in women with multiple induced abortions

目的:探究多次人工流产者术后应用戊酸雌二醇联合安宫黄体酮序贯治疗效果。方法:以2018年7月-2019年7月本院收治的多次人工流产者167例,分为观察组84例和对照组83例,两组术后均常规消炎促宫缩治疗,观察组采用戊酸雌二醇联合安宫黄体酮序贯治疗,对比两组术后阴道流血时间、宫腔粘连发生率、子宫内膜厚度、月经复潮时间及血运情况[阻力指数(RI)、搏动指数(PI)、子宫内膜螺旋动脉血流收缩末期峰值与舒张末期峰值的比值(S/D)]。结果:观察组宫腔粘连发生率(13.1%)小于对照组(33.7%),术后阴道流血时间(6.2±1.3d)和月经复潮时间(31.2±3.4d)均低于对照组(7.9±1.3d、36.9±3.8d)(P<0.05)。观察组子宫内膜厚度(8.74±0.98mm)大于对照组(7.18±1.04mm),且RI、PI和S/D均小于对照组,并发症发生率(16.7%)低于对照组(41.0%)(P<0.05)。结论:对多次人工流产者术后采用戊酸雌二醇联合安宫黄体酮序贯治疗,可促进术后子宫机能恢复,改善血运,修复子宫内膜。

Objective: To explore the effect of sequential treatment of estradiol valerate combined with medroxyprogesterone in the recovery of women with multiple induced abortions. Methods: 167 women with multiple induced abortions were included and were divided into observation group and control group between July 2018 and July 2019. After abortion, 83 women in the control group were treated with conventional therapy, such as antiphlogosis and promoting uterine contraction, and 84 women in the observation group were treated with estradiol valerate combined with medroxyprogesterone except to the conventional therapy. After treatment, the postoperative vaginal bleeding time, uterine adhesion incidence, endometrial thickness, menstrual recovery time, and the uterine hemodynamic indicators, such as resistance index(RI), pulsatility index(PI), the ratio of the end-systolic peak, and the end-diastolic peak blood flow of the intimal spiral artery(S/D) of the women were compared between the two groups. Results: The incidence of intrauterine adhesions(13.1%) of the women in the observation group was significant lower than that(33.7%) of the women in the control group, and the postoperative vaginal bleeding time(6.2±1.3 d) and menstrual recovery time(31.2±3.4 d) of the women in the observation group were significant shorter than those(7.9±1.3 d and 36.9±3.8 d) of the women in the control group(P<0.05). The endometrial thickness(8.74±0.98 mm) of the women in the observation group was significant greater than that(7.18±1.04 mm) of the women in the control group, but the values of RI, PI and S/D of the women in the observation group were significant lower. The complication rate(16.7%) of the women in the observation group was significant lower than that(41.0%) of the women in the control group(P<0.05). Conclusion: Sequential treatment by estradiol valerate combined with medroxyprogesterone for women with multiple induced abortions has better effect, which can promote the recovery of their uterine physiological function, improve their uterine blood supply and endometrial recovery.