超声监测子宫内膜厚度在稽留流产术后应用雌激素提高妊娠率中的评估价值

Value of ultrasound monitoring of endometrial thickness in assessing pregnancy rate improvement after estrogen administration following a missed abortion

目的分析稽留流产术后应用雌激素超声监测子宫内膜厚度在提高妊娠率中的临床价值。方法回顾性选取2022年1月至2023年6月在慈溪市妇幼保健院进行稽留流产吸刮宫术的患者86例为研究对象,按照不同治疗方式分为对照组、观察组各43例。对照组术后予常规治疗,不采用任何药物治疗,观察组术后予雌激素治疗。比较两组临床疗效、子宫内膜厚度、宫腔粘连情况及再次妊娠率。结果观察组子宫内膜厚度在组间、交互以及时间作用上差异均有统计学意义(F组间=129.49,F交互=14.25,F时间=146.64,均P<0.001),宫腔粘连情况优于对照组(χ^(2)=4.34,P<0.05),观察组临床有效率[88.37%(38/43)比69.76%(30/43)]、再次妊娠率显著优于对照组[46.54%(20/43)比13.95%(6/43)],差异均有统计学意义(Z=2.35,P=0.019,χ^(2)=10.81,P<0.05)。结论稽留流产患者术后应用雌激素治疗,对子宫内膜厚度改善显著,对促进月经恢复、减少宫腔粘连具有积极作用,有利于提高再次妊娠率,临床价值较高。

Objective To analyze the clinical value of ultrasound monitoring of endometrial thickness in assessing pregnancy rate improvement after estrogen administration following a missed abortion.Methods A retrospective study was conducted on 86 patients who underwent surgical abortion at Cixi Maternal and Child Health Hospital from January 2022 to June 2023.Based on the treatment received,the patients were divided into two groups:a control group and an observation group,with 43 patients in each group.The control group received only routine postoperative care without any medication,while the observation group received estrogen treatment after surgery.The clinical efficacy,endometrial thickness,intrauterine adhesion and re-pregnancy rate were compared between the two groups.Results In the observation group,there was significant difference in endometrial thickness in terms of intergroup,group-by-time interaction,and time effect(F intergroup=129.49,F interaction=14.25,F time=146.64,all P<0.001).Intrauterine adhesions were less severe in the observation group compared with the control group(χ^(2)=4.34,P<0.05).The clinical effective rate was significantly higher in the observation group than in the control group[88.37%(38/43)vs.69.76%(30/43),Z=2.35,P=0.019].Additionally,the rate of re-pregnancy was significantly higher in the observation group than in the control group[46.54%(20/43)vs.13.95%(6/43),χ^(2)=10.81,P<0.05].Conclusion Patients who have retained abortion can benefit from ultrasound examination to assess endometrial thickness after estrogen administration.This approach significantly enhances endometrial thickness,promotes menstrual recovery,and reduces intrauterine adhesions.It also improves the rate of re-pregnancy and is highly valuable in clinical settings.