不同人工流产术对妇女月经复潮时间、阴道出血时间及术后宫腔粘连发生率的影响

Effects of different induced abortions on women's menstrual re-fluid time,vaginal bleeding time and the incidence of postoperative intrauterine adhesion

目的探讨不同人工流产术对妇女月经复潮时间、阴道出血时间及术后宫腔粘连发生率的影响。方法选取嘉兴市第二医院2019年1月至2021年1月行B超监视下无痛人流术的妇女260例纳入B超组,行微创内窥可视人工流产术的妇女260例纳入可视组,观察比较两组妇女手术情况,术后月经复潮时间、阴道出血时间,术后腹痛情况及宫腔粘连等并发症发生率。结果可视组妇女手术时间为(3.37±0.84)min,显著短于B超组的(6.59±2.03)min(t=23.68,P < 0.001);可视组妇女术中出血量为(15.87±5.65)mL,显著少于B超组的(33.04±10.44)mL(t=23.33,P < 0.001);可视组妇女术后阴道出血时间、月经复潮时间分别为(3.16±1.58)d、(30.37±6.13)d,均显著短于B超组的(4.23±1.83)d、(32.07±4.25)d(t=7.10、3.69,均P < 0.001);两组妇女术后腹痛等级、腹痛时间比较,差异均无统计学意义(均P > 0.05);可视组完全流产率(98.85%)显著高于B超组(96.15%)(χ^(2)=3.86,P < 0.05),并发症发生率(2.31%)显著低于B超组(5.77%)(χ^(2)=4.01,P < 0.05);可视组宫腔粘连发生率(1.15%)与B超组(3.46%)比较,差异无统计学意义(P > 0.05)。结论微创内窥可视人工流产术与B超监视下无痛人流术均具有良好的无痛效果,但微创内窥可视人工流产术更有利于减少手术影响,促进妇女术后恢复,安全性更好。

Objective To investigate the effects of different induced abortions on women's menstrual re-fluid time,vaginal bleeding time and the incidence of postoperative intrauterine adhesion.Methods A total of 260 women who underwent painless abortion under ultrasound surveillance in The Second Hospital of Jiaxing from January 2019 to January 2021 were included in the ultrasound group.An additional 260 women who underwent minimally invasive endoscopic visual abortion were included in the endoscopy group.Operation-related indexes were compared between the two groups.Menstrual re-fluid time,vaginal bleeding time,postoperative abdominal pain and the incidence of postoperative intrauterine adhesion were compared between the two groups.Results Operative time in the endoscopy group was significantly shorter than that in the ultrasound group[(3.37±0.84)minutes vs.(6.59±2.03)minutes,t=23.68,P<0.001].The amount of intraoperative blood loss in the endoscopy group was significantly less than that in the ultrasound group[(15.87±5.65)mL vs.(33.04±10.44)mL,t=23.33,P<0.001].Postoperative vaginal bleeding time and menstrual re-fluid time in the endoscopy group were(3.16±1.58)days and(30.37±6.13)days,respectively,which were significantly shorter than those in the ultrasound group[(4.23±1.83)days,(32.07±4.25)days,t=7.10,3.69,P<0.001].There were no significant differences in the severity and duration of postoperative abdominal pain between the two groups(both P>0.05).Complete abortion rate in the endoscopy group was significantly higher than that in the ultrasound group[98.85%vs.96.15%,χ^(2)=3.86,P<0.05].The incidence of complications in the endoscopy group was significantly lower than that in the ultrasound group(2.31%vs.5.77%,χ^(2)=4.01,P<0.05).There was no significant difference in the incidence of postoperative intrauterine adhesion between the endoscopy and ultrasound groups(1.15%vs.3.46%,P>0.05).Conclusion Both minimally invasive endoscopic visual abortion and B-ultrasound-guided painless abortion have painless effects.Minimally invasive endoscopic visual abortion produces less postoperative impact,leads to better postoperative recovery,and is safer than B-ultrasound-guided painless abortion.