下腹部经皮电刺激对稽留流产及不全流产妇女术后子宫内膜厚度及血流动力学影响

The influence of postoperative lower abdominal transcutaneous electrical stimulation therapy on the endometrial thickness and endometrial blood flow of women with missed abortion or incomplete abortion

目的:探讨下腹部经皮电刺激对稽留流产及不全流产妇女术后子宫内膜厚度及血流动力学的影响。方法:选取2016年1月—2018年1月因稽留流产、不全流产而行清宫术妇女144例,按随机数字表法分为观察组与对照组各72例。术后对照组采用常规药物治疗,观察组在对照组基础上加行下腹部经皮电刺激治疗。比较两组术后阴道出血、月经复潮及并发症情况,测定子宫内膜厚度及子宫内膜螺旋动脉搏动指数(PI)、阻力指数(RI)、血流收缩末期峰值与舒张末期峰值的比值(S/D)。结果:治疗后观察组的阴道出血量、出血时间及月经复潮时间均低于对照组,子宫内膜厚度高于对照组,RI、PI及S/D均低于对照组,月经量少、腹痛发生率(2.8%、2.8%)低于对照组(16.7%、12.5%)(均P<0.05),盆腔感染及宫腔粘连发生率两组无差异(P>0.05)。结论:对稽留流产及不全流产妇女清宫术后辅助应用下腹部经皮电刺激能够促进子宫内膜厚度增加并改善内膜血流动力学状态,减少术后阴道出血并促进月经复潮,预防月经量少等并发症。

Objective:To investigate the influence of postoperative transcutaneous electrical stimulation therapy on the endometrial thickness and endometrial blood flow of women with missed abortion or incomplete abortion.Methods:144 women who underwent curettage due to missed abortion or incomplete abortion were enrolled and were randomly divided into the observation group and the control group(72 cases in each group)from January 2016 to January 2018.The women in the control group were given conventional treatment and the women in the observation group were treated by transcutaneous electrical stimulation therapy combined with conventional treatment.The situations of postoperative vaginal bleeding,menstrual recovery,and rate of complications of women were compared between the two groups.The endometrial thickness and pulsation index(PI),resistance index(RI),ratio of peak systolic velocity to end diastolic velocity(S/D)of uterine spiral artery of all included women were measured.Results:After treatment,the volume of vaginal bleeding,the time of vaginal bleeding,and menstrual recovery time of women in the observation group were significant lower than those of women in the control group(P<0.05),the endometrial thickness of women in the observation group was significant higher than that of women in the control group,while the values of RI,PI and S/D of women in the observation group was significantly lower than those of women in the control group(P<0.05).The incidences of less menstrual volume and abdominal pain of women in the observation group were 2.8%and 2.8%,respectively,which were significant lower than those(16.7%and 12.5%)of women in the control group(P<0.05).There were no significant difference in the rates of pelvic infection and intrauterine adhesion(IUA)between the two groups(P>0.05).Conclusion:The lower abdominal transcutaneous electrical stimulation used for treating women with missed abortion or incomplete abortion after curettage can increase of endometrial thickness and improve the hemodynamic state of the endometrium,can reduce postoperative vaginal bleeding,promote menstrual rehydration,and prevent less menstrual amount and other complications.