戊酸雌二醇片促进人工流产后子宫内膜修复预防宫腔粘连的疗效

Efficacy of estradiol valerate tablets in promoting endometrial repair after induced abortion and preventing intrauterine adhesions

目的探讨戊酸雌二醇片促进人工流产后子宫内膜修复预防宫腔粘连的效果。方法收集2016年1月~2022年1月在我院进行人工流产术的患者110例,采用随机数字表法分组,即对照组、观察组,均55例。对照组在人工流产术后10d开始予以甲羟孕酮片,10mg/次,1次/d,共治疗14d。观察组在人工流产术后5d开始予以戊酸雌二醇片联合甲羟孕酮片治疗,戊酸雌二醇片,1mg/次,2次/d,采用周期序贯疗法进行治疗,共治疗3周,甲羟孕酮片同对照组。结果观察组阴道出血时间(3.42±1.13)d、月经复潮时间(33.56±3.82)d、周期性腹痛发生率1.82%均显著低于对照组(t=8.397,P=0.000;t=27.402,P=0.000;χ^(2)=5.930,P=0.015),两组月经量减少占比及子宫内膜厚度比较,P>0.05,且观察组无闭经者。观察组宫腔粘连总发生率1.82%显著低于对照组(2=5.930,P=0.015)。治疗前,两组血清性激素水平比较,P>0.05,治疗后,两组血清性激素水平均显著优于对照组,P<0.05,进一步组间比较,观察组LH(17.86±2.02)U/L、FSH(18.66±2.35)U/L均显著高于对照组,P<0.05,E2(206.91±16.77)pg/ml、P(6.92±1.09)nmol/L均显著低于对照组,P<0.05。结论戊酸雌二醇片可有效促进人工流产后子宫内膜的修复,同时还可以有效预防宫腔粘连,安全性高,且疗效受到患者认可。

Objective To analyse the clinical effect of estradiol valerate tablets on preventing intrauterine adhesion after induced abortion.Methods A total of 110 patients who underwent artificial abortion in our hospital from January 2016 to January 2022 were collected and divided into groups by random number table method,namely the control group and the observation group,55 cases in each.The control group was given medroxyprogesterone tablets 10d after induced abortion,10 mg/time,once/d,for a total of 14d.The observation group was treated with estradiol valerate tablets(1mg/time,2 times/d)combined with medroxyprogesterone tablets 5 days after induced abortion.Treatment with cycle sequential therapy,3 weeks in total.The medroxyprogesterone tablet treatment regimen was consistent with the control group.Results The vaginal bleeding time(3.42±1.13)d,the menstrual rehydration time(33.56±3.82)d,and the incidence of periodic abdominal pain 1.82%in the observation group were significantly lower than those in the control group(t=8.397,P=0.000;t=27.402,P=0.000;χ^(2)=5.930,P=0.015).The menstrual flow reduction rate and endometrial thickness between the two groups were compared,P>0.05,and there was no amenorrhea in the observation group.The incidence of intrauterine adhesion in the observation group was 1.82%,which was significantly lower than that in the control group(2=5.930,P=0.015).Before treatment,the comparison of serum sex hormone levels in the two groups,P>0.05,after treatment,the serum sex hormone levels in the two groups were significantly better than those in the control group,P<0.05,compared between groups,the observation group LH(17.86±2.02)U/L,FSH(18.66±2.35)U/L were significantly higher than the control group,P<0.05,E2(206.91±16.77)pg/ml and P(6.92±1.09)nmol/L in the observation group were significantly lower than those in the control group,P<0.05.Conclusion The use of estradiol valerate tablets after artificial abortion can effectively promote the repair of endometrium,and reduce the incidence of intrauterine adhesions.It has high safety and the clinical efficacy is recognized by patients.