不同剂量雌二醇地屈孕酮阴道给药对人工流产术后女性月经恢复及子宫内膜厚度的影响

Effects of vaginal administration of different doses of estradiol and dydrogesterone on menstruation recovery and endometrial thickness in women after induced abortion

目的探究不同剂量雌二醇地屈孕酮阴道给药对人工流产术后女性月经恢复及子宫内膜厚度的影响。方法选取2020年6月至2021年6月于上饶卫生学校附属医院(广丰妇幼保健院)行人工流产术的60例患者作为研究对象,随机分为观察组与对照组,每组30例。观察组给予高剂量雌二醇地屈孕酮片治疗,对照组术后给予低剂量雌二醇地屈孕酮片治疗,比较两组阴道流血情况、月经恢复情况、性激素[雌二醇(E2)、卵泡刺激素(FSH)和黄体生成素(LH)]水平、子宫内膜厚度、宫腔粘连发生率及不良反应发生率。结果观察组阴道流血时间、首次月经复潮时间均短于对照组,阴道流血量少于对照组,复潮后月经量多于对照组,差异有统计学意义(P<0.05)。治疗后,两组E2水平均高于治疗前,FSH、LH水平均低于治疗前,差异有统计学意义(P<0.05),但组间比较差异无统计学意义。两组子宫内膜厚度组间、时间、交互比较差异有统计学意义(P<0.05)。术后第1天,两组子宫内膜厚度比较差异无统计学意义;第1、3、6个疗程后,两组子宫内膜厚度均厚于前一时间点,且观察组厚于对照组,差异有统计学意义(P<0.05)。观察组治疗后宫腔粘连总发生率为6.67%,低于对照组的26.67%,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论高剂量雌二醇地屈孕酮可有效增强人工流产患者的止血效果,并更有助于促进月经和子宫内膜恢复,降低宫腔粘连发生率,同时,不增加不良反应发生风险,值得临床推广应用。

Objective To investigate the effects of vaginal administration of different doses of estradiol and dydrogesterone on menstruation recovery and endometrial thickness in women after induced abortion.Methods 60 patients undergoing induced abortion in Guangfeng Maternal and Child Health Hospital(Affiliated to Shangrao Health School)from June 2020 to June 2021 were selected as the study subjects,and they were randomly divided into the observation group and the control group,with 30 cases in each group.The observation group was treated with high-dose estradiol dydrogesterone tablets,while the control group was treated with low-dose estradiol dydrogesterone tablets,the situation of vaginal bleeding,menstruation recovery,sex hormones(estradiol[E2],follicle stimulating hormone[FSH]and luteinizing hormone[LH]levels,endometrial thickness,the incidence rates of intrauterine adhesion and adverse reactions were compared between the two groups).Results The vaginal bleeding time and the first menstrual recovery time in the observation group were shorter than those in the control group,the vaginal bleeding volume was less than that in the control group,and the menstrual volume after the recovery was more than that in the control group,the differences were statistically significant(P<0.05).After treatment,the E2 levels of the two groups were higher than those before treatment,and the FSH and LH levels were lower than those before treatment,the differences were statistically significant(P<0.05),but there was no significant difference between the two groups.There were significant differences of endometrial thickness between two groups of group,time points and interaction(P<0.05).On the 1 d after operation,there was no significant difference in endometrial thickness between the two groups;after the 1st,3rd and 6th courses of treatment,the endometrial thickness of the two groups was thicker than that at the previous time point,and the observation group was thicker than the control group,the differences were statistically significant(P<0.05).The total incidence of intrauterine adhesions after treatment in the observation group was 6.67%,which was lower than 26.67%in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion High-dose estradiol dydrogesterone can effectively enhance the hemostatic effect of patients with induced abortion,and it is more helpful to promote the recovery of menstruation and endometrium,reduce the incidence of indoi trauterine adhesions,and do not increase the risk of adverse reactions,and is worthy of clinical promotion and application.