屈螺酮炔雌醇治疗子宫切口憩室患者药物流产后宫内残留的临床研究

Clinical Study of Drosterone Ethinylestradiol in the Treatment of Intrauterine Residue after Medical Abortion in Patients with Uterine Incision Diverticulum

目的:探讨屈螺酮炔雌醇治疗子宫切口憩室患者药物流产后宫内残留的效果。方法:选取2022年1月至2023年3月清远市人民医院收治的60例经阴道彩色超声筛查为剖宫产术后子宫切口憩室且药物流产排胎后经B超证实宫内存在组织物残留的患者,随机分为对照组和观察组,各30例。对照组患者给予米非司酮治疗,观察组患者给予米非司酮联合屈螺酮炔雌醇治疗。比较两组患者治愈情况、临床指标、人绒毛膜促性腺激素β(β–HCG)水平、不良反应、并发症发生情况。结果:治疗后、第1次月经干净后,观察组患者治愈率高于对照组,差异具有统计学意义(P <0.05)。观察组患者阴道流血停止时间、宫腔内残留物排出时间、月经复潮时间均短于对照组,差异具有统计学意义(P <0.05)。治疗后2周、治疗后1个月,观察组患者血清β–HCG水平低于对照组,差异具有统计学意义(P <0.05)。两组患者不良反应发生率、并发症发生率比较,差异无统计学意义(P> 0.05)。结论:在米非司酮治疗的基础上,联合屈螺酮炔雌醇治疗子宫切口憩室患者药物流产后宫内残留的效果更优,有助于改善患者临床症状,促进宫腔内残留物排出。

Objective To investigate the effect of drospiroone ethinylestradiol in the treatment of intrauterine residue after medical abortion in patients with uterine incision diverticulum.Methods Sixty patients treated in Qingyuan People's Hospital from January 2022 to March 2023 who were screened by vaginal color ultrasound as uterine incision diverticulum after cesarean section and confirmed by B-ultrasonography after medical abortion were randomly divided into a control group and an observation group,with 30 cases in each group.The control group was given mifepristone treatment,the observation group was given mifepristone combined with drospiroone ethinylestradiol treatment.The curative status,clinical indexes,human chorionic gonadotropinβ(β-HCG)level,adverse reactions and complications were compared between the two groups.Results After treatment and after the first menstruation,the cure rate of the observation group were higher than that of the control group,the differences were statistically significant(P<0.05).Vaginal bleeding stop time,intrauterine residue discharge time and menstrual rehydration time in the observation group were shorter than those in the control group, and the differences were statistically significant (P < 0.05). 2 weeks after treatment and 1 month after treatment, the β-HCG level in the observation group were lower than that in the control group, and the differences were statistically significant (P < 0.05). There was no significant difference in the incidence of adverse reactions and complications between the two groups (P > 0.05). Conclusion On the basis of mifepristone treatment, the combination of drospiroone ethinylestradiol has a better effect on the treatment of residual intrauterine residue in patients with uterine incision diverticulum after drug abortion, which helps to improve clinical symptoms and promote the discharge of intrauterine residue.