哺乳期瘢痕子宫人工流产手术方法及风险探讨

Methods and Risks of Induced Abortion in Lactation Cicatricial Uterus

目的 探讨哺乳期瘢痕子宫人工流产手术的方法及风险。方法 随机选取2018年2月—2021年10月福建省福能集团总医院收治的80例行人工流产的哺乳期瘢痕子宫患者为研究对象,根据随机数表法分为观察组、对照组,各40例。对照组接受以负压吸引术为支撑的人工流产术,观察组接受利用米非司酮药物、米索前列醇药物+彩超引导下行负压吸引人工流产术。比较两组患者的手术效果及宫颈松弛情况、并发症发生率。结果 观察组的宫颈松弛总有效率明显高于对照组(95.00%vs 80.00%),差异有统计学意义(P<0.05)。观察组术中出血量、疼痛(VAS)评分和手术时间均优于对照组,差异有统计学意义(t=11.261、30.066、8.583,P<0.05)。观察组并发症发生率为5.00%,较对照组的22.50%更低,差异有统计学意义(χ^(2)=5.165,P=0.023)。结论 针对哺乳期瘢痕子宫患者利用米非司酮+米索前列醇+彩超引导下行人工流产术治疗有利于宫颈松弛、减少术中出血量、减轻患者疼痛、降低手术并发症发生率,具有良好的手术效果。

Objective To explore the methods and risks of induced abortion in lactation with cicatricial uterus.Methods Eighty patients with lactation cicatricial uterus undergoing induced abortion admitted to Fujian Funeng Group General Hospital from February 2018 to October 2021 were randomly selected as the research objects,and were divided into observation group and control group according to random number table method,with 40 cases in each group.The control group received induced abortion supported by negative pressure aspiration,and the observation group received induced abortion guided by mifepristone,misoprostol and color ultrasound under negative pressure aspiration.The operative effect,cervical relaxation and complication rate were compared between the two groups.Results The total effective rate of cervical relaxation in observation group was significantly higher than that in control group(95.00%vs 80.00%),and the difference was statistically significant(P<0.05).The intraoperative blood loss,pain score(VAS)and operation time in the observation group were better than those in the control group,and the differences were statistically significant(t=11.261,30.066,8.583,P<0.05).The incidence of complications in the observation group was 5.00%,lower than 22.50%in the control group,and the differences were statistically significant(χ^(2)=5.165,P=0.023).Conclusion For patients with lactation uterus with scar tissue,induced abortion guided by mifepristone+misoprostol+color ultrasound is beneficial to cervical laxity,reduce intraoperative blood loss,relieve patients'pain and reduce the incidence of surgical complications,and has good surgical effect.