雌孕激素人工周期及复方口服避孕药对人工流产术后子宫内膜修复的影响研究

Study on the effect of combination oral contraception and artificial cycle on endometrium regeneration after induced abortion

目的探讨雌二醇+地屈孕酮人工周期疗法、复方口服避孕药炔雌醇环丙孕酮对人工流产术后子宫内膜修复的效果。方法选取240例人工流产女性随机分为人工周期组、COC组和对照组。比较术后阴道流血时间、月经复潮时间、月经量、子宫内膜厚度、子宫内膜血流及宫腔粘连发生率。结果人工周期组及COC组阴道流血时间均少于对照组,月经复潮时间均短于对照组;人工周期组月经量多于对照组,而COC组月经量少于对照组;人工周期组术后14d子宫内膜厚度大于对照组,COC组子宫内膜厚度小于对照组;术后14d人工周期组及COC组子宫内膜血流均优于对照组,人工周期组及COC组无明显差异;术后人工周期组及COC组的宫腔粘连发生率均少于对照组。结论雌孕激素人工周期及复方口服避孕药均能有效减少术后阴道流血时间、促进月经来潮、预防宫腔粘连,人工周期治疗能增加子宫内膜厚度,增加子宫内膜血流,有效修复子宫内膜,复方短效口服避孕药也能促进子宫内膜修复。

Objective:To explore the effect of estradiol+dydrogesterone and ethinylestradiol+cyproterone(Diane-35)on endometrium regeneration after induced abortion.Methods:240 women with induced abortion were randomly divided into artificial cycle group,combination oral contraception group and control group.The vaginal bleeding time,menstrual recovery time,menstrual volume,endometrium thickness,endometrial blood flow and the incidence of intrauterine adhesions were compared among the three groups.Results:The vaginal bleeding time of artificial cycle group and COC group was significantly shorter than that in control group,and the menstrual recovery time was significantly shorter than that in control group.The amount of menstruation in the artificial cycle group was more than that in the control group,while that in the COC group was less than the control group.14 days after abortion,the thickness of endometrium in the artificial cycle group was significantly thicker than that in the control group,and that in the COC group was significantly thinner than that in the control group.The endometrial blood flow of the artificial cycle group and COC group was better than that of the control group,and there was no significant difference between the artificial cycle group and COC group.The incidence of postoperative intrauterine adhesions in the artificial cycle group and COC group was lower than that in the control group.Conclusion:The artificial cycle of estrogen and progesterone and the combination oral contraception can effectively reduce the vaginal bleeding time,promote the menstrual recovery and prevent the occurrence of intrauterine adhesion after induced abortion.The artificial cycle treatment can increase the thickness of endometrium,increase the endometrial blood flow,and effectively repair the endometrium.The combination oral contraception can also promote endometrium regeneration.