人工流产术围术期综合干预措施替代口服抗生素的短期临床效果研究

Short-term clinical efficacy of the perioperative comprehensive interventions as the antibiotic alternative during abortion of women

目的:探讨围术期综合干预措施对人工流产术的临床疗效,为人工流产围手术期管理提供一种安全、有效且无抗生素的新型替代方案。方法:选择2020年3月-2022年3月本院就诊要求行人工流产术且既往流产史≥2次的女性240例,随机分为两组,综合组采用阴道冲洗、阴道及宫颈喷涂抗菌凝胶、术后放置宫颈抗菌膜等综合干预措施,对照组采用常规口服抗生素预防。比较两组术后感染发生率、不良反应发生率、月经复潮情况、子宫内膜厚度恢复、宫腔粘连发生率及总体治疗有效率。结果:综合组术后感染发生率(1.7%)与对照组(3.3%)无差异(P>0.05);不良反应发生率(1.7%)低于对照组(7.5%),月经复潮时间(32.9±6.3d)、内膜厚度恢复(7.01±0.53 mm)优于对照组(55.4±9.1d、5.72±0.51 mm),宫腔粘连发生率(1.7%)低于对照组(9.2%),总治疗费用(5173±325元)高于对照组(4540±286元)(均P<0.05)。结论:人工流产术围手术期综合干预措施安全有效,能够加速女性术后恢复,降低并发症发生,是值得推广的无抗生素替代方案。

Objective:To investigate the clinical efficacy of the perioperative comprehensive interventions as the antibiotic-free alternative during abortion of women,and to provide a safe,effective and antibiotic-free alternative for the perioperative management of the women with abortion.Methods:240 women with two times of the abortion history who wanted abortion again were selected and were randomly divided into study group and control group from March 2020 to March 2022.The women in the observation group received comprehensive interventions during abortion,including the vaginal irrigation,the application of antimicrobial hydrogel on the vagina and cervix and the postoperative placement of a cervical antimicrobial membrane,while the women in the control group received the routine systemic antibiotic prophylaxis.The postoperative infection rate,the adverse reaction rate,the menstrual recovery,the endometrial thickness recovery,the intrauterine adhesion rate and the overall treatment effectiveness of the women were compared between the two groups.Results:There was no significant difference in the incidence of postoperative infection(1.7%vs.3.3%)of the women between the two groups(P>0.05).The incidence of adverse reactions(1.7%)of the women in the observation group was significantly lower than that(7.5%)of the women in the control group.The recovery time of menstruation(32.9±6.3d)or the endometrial thickness(7.01±0.53mm)of the women in the observation group was significantly better than that(55.4±9.1d or 5.72±0.51mm)of the women in the control group.The incidence of intrauterine adhesion(1.7%)of the women in the observation group was significantly lower than that(9.2%)of the women in the control group.The total cost(5173±325 yuan)of the women in the observation group was significantly higher than that(4540±286 yuan)of the women in the control group(all P<0.05).Conclusion:The perioperative comprehensive interventions during the abortion of the women are safe and effective,can which accelerate the postoperative recovery and reduce the complications,and it is the antibiotic-free alternative and is worth to promoting.