戊酸雌二醇联合地屈孕酮治疗不同β-HCG水平不全流产的疗效观察

目的探讨戊酸雌二醇联合地屈孕酮治疗不同β-HCG水平不全流产的疗效。方法选择人工流产后和药物流产后14 d复查的不完全性流产者80例,其中β-HCG<1000 IU/L和β-HCG>1000 IU/L且<2000 IU/L者各40例,残留物经线均<20 mm。β-HCG<1000 IU/L患者随机分为治疗1组和对照1组各20例,β-HCG>1000 IU/L且<2000 IU/L患者随机分为治疗2组和对照2组各20例。治疗1组和治疗2组予戊酸雌二醇(补佳乐)4mg,1次/d,共21 d,用药第12天加用地屈孕酮(达芙通)10mg,2次/d,共10d。对照组,不用药,期待治疗。两组随访2个月并比较疗效。结果治疗1组和治疗2组效率分别为70.0%,95.00%,对照1组与对照2组35.00%、45.00%,,治疗1组和治疗2组均比相应对照组有效。治疗1组比治疗2组有效率更高,差异有统计学意义(P<0.05);治疗1组和治疗2组均较相应对照组β-HCG下降明显,差异有统计学意又(P<0.05);四組患者出现胃肠道不适、乳房胀痛或头晕头痛等不良反应的比例均<10%,人工周期药物治疗组并无不良反应的规律性增加。结论戊酸雌二醇联合地屈孕酮治疗不全流产对于β-HCG水平<1000 IU/L和β-HCG>100IU/L1L<20001U/L的患者均是一种安全、有效的方法。

Objective To invesrigate the efiacy of strndiol valerare combined with didroxyprogesterone in the treatmnenr of incomplete aborion with difrentβ-HCG levels.Methods 80 cases of incomplete aborion were cllected 14 days after induced abortion and drug abortion.There were 40 cases ofβ-HCG<1000 IU/L and 40 cases of 1000 IU/L<β-HCG<2000 IU/L repectivly,and the longitude of the residue was<20 mm.Patients withβ-HCG<1000 IU/L were randomly divided into treatment group 1 and control group 1,with 20 cases in each group.Similarly,patients with 1000 IU/L<β-HCG<2000 IU/L were randomly divided into treatment group 1 and control group I,with 20 cases in each group.Treatment group 1 and treatment group 2 were given estradiol valerate 4 mg once a day for 21 days.Didroxyprogesterone 10 mg was added on the 12th day,twice a day for 10 days.The control group was given expectant treatment without medication.The two groups were fllowved up for 2 months and the curative ffects were compared.Results The effective rates of treatment group 1 and treament group 2 were 70.0%and 95.00%respectively.Control group 1 and control goup 2 were 35.00%and 4500%respectively.Treatment group I and treatment group 2 were more eficive than the corresponding control group.The fiecive rate of treaemnent group 1 was higher than that of treaemnent group2(P<0.05)。β-HCG in treatmnent group 1 and treatment group 2 decreased signific antly compared with the corresponding control group(P<0.05).The proportion of adverse reactions such as gastrointesinal discomfort,breast pain or dizziness and headache in the four groups was les than 10%.There was no regular increase in adverse reactions in the treatment group.Conclusion Estradiol valerate combined with didroxyprogesterone in the treatment of incomplete aborrion is a safe and efective method for patients withβ-HCG<000U/L and 1000 IU/L<β-HCG<2000 IU/L.