雌二醇片/雌二醇地屈孕酮片复合包装片与坤泰胶囊在稽留流产清宫术患者中的应用效果观察

The application effect of complex packing estradiol tablets/estradiol and dydrogesteronetablets and Kuntai capsules in patients undergoing uterine curettage for missed abortion

目的探讨雌二醇片/雌二醇地屈孕酮片复合包装片与坤泰胶囊对稽留流产清宫术患者术后宫腔粘连及子宫内膜修复的影响。方法将2018年7月至2019年7月在我院行稽留流产清宫术治疗者136例,采用信封法分为观察组与对照组各68例,对照组采用坤泰胶囊治疗,观察组联合雌二醇片/雌二醇地屈孕酮片复合包装片、坤泰胶囊治疗,比较两组患者术后宫腔黏连及子宫内膜修复情况。结果观察组出血量、出血时间、月经复潮时间、腹痛持续时间均显著少于对照组(P<0.05),两组吸宫次数及阴道分泌物增多、下腹痛、经量减少发生率方面比较差异无统计学意义(P>0.05);观察组月经及宫腔形态恢复情况明显优于对照组(P<0.05);治疗后观察组卵泡刺激素、雌二醇高于对照组,促黄体生成素、孕激素低于对照组(P<0.05);治疗后观察组C反应蛋白、肿瘤坏死因子、白介素-6水平明显低于对照组(P<0.05);观察组治疗后宫腔黏连发生率5.88%明显低于对照组19.12%(P<0.05);观察组治疗后子宫内膜厚度高于对照组,子宫动脉阻力指数低于对照组(P<0.05),但两组子宫内膜分型及子宫内膜下血流参数子宫动脉搏动指数、收缩/舒张期速度比比较差异无统计学意义(P>0.05)。结论雌二醇片/雌二醇地屈孕酮片复合包装片与坤泰胶囊的应用,可有效促进稽留流产清宫术患者宫腔形态及月经恢复正常,改善性激素水平,降低炎症因子水平及宫腔黏连发生率,对临床治疗具有指导性意义。

Objective To investigate the effect of complex packing estradiol tablets/estradiol and dydrogesteronetablets and Kuntai capsules on postoperative intrauterine adhesions and endometrial repair in patients undergoing uterine curettage for missed abortion.Methods Using the envelope method,136 casesundergoing uterine curettage for missed abortion in our hospital between July2018 and July 2019 were divided into an observation group and a control group,68 in each group.The control group was treated with Kuntai capsules,while the observation group was treated with complex packing estradiol tablets/estradiol and dydrogesteronetablets and Kuntai capsules.Postoperative intrauterine adhesions and endometrial repair were compared between the two groups.Results The bleeding volume,bleeding time,menstrual recovery time,and duration of abdominal pain in the observation group were significantly less or shorter thanthose in the control group(P<0.05),but there were no significant differences in thetime of uterine suction,the incidences of increased vaginal discharge,lower abdominal pain,and reduction of menstrual volume(P>0.05).The recovery of menstruationand uterine cavity shape in the observation group was significantly better than that in the control group(P<0.05).After treatment,follicle stimulating hormone and estradiol in the observation groupwere higher than those in the control group,while luteinizing hormone and progesterone were lower than those in the control group(P<0.05).After treatment,the levels of C-reactive protein,tumor necrosis factor and interleukin-6 in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the incidence of intrauterine adhesions in the observation group was 5.88%,that was significantly lower than 19.12%in the control group(P<0.05).The observation group had significantly larger endometrial thickness,and significantly lower uterine artery resistance index than the control group did(P<0.05).But there were no significant differences between the two groups in terms of endometrial classification,uterine artery pulsatility index,and systolic/diastolic velocity(P>0.05).Conclusion Both complex packing estradiol tablets/estradiol and dydrogesteronetablets and Kuntai capsules can effectively promote the recovery of the uterine cavity shape and menstruation,improve the levels of sex hormones,and reduce the levels of inflammatory factorsin patients undergoing uterine curettage formissed abortion.Italso can decrease the incidence of uterine adhesions.Thus,it has a guiding significance for clinical treatment.