稽留流产患者清宫术后口服避孕药的临床疗效评价

Evaluation of Clinical Efficacy of Oral Contraceptive in Patients with Missed Abortion after Curettage

目的:探讨稽留流产患者实施清宫术后口服避孕药的临床疗效。方法:选取本院妇产科2017年1—12月收治的80例稽留流产患者,按随机数字表法分为常规组和干预组,各40例。两组均实施常规清宫术。术后,常规组运用抗生素及益母草治疗,干预组在常规组的基础上采取口服避孕药(屈螺酮炔雌醇片)治疗,分析两组患者术后恢复、性激素水平变化、术后并发症、术后6个月再妊娠及再稽留流产状况。结果:干预组阴道持续性流血时间、月经复潮时间均明显短于常规组,差异均有统计学意义(P<0.05)。术后2周,干预组子宫内膜厚度、雌二醇均高于常规组,而黄体生成素、孕酮均低于常规组,差异均有统计学意义(P<0.05)。干预组术后2周卵泡刺激素与常规组比较,差异无统计学意义(P>0.05)。干预组术后盆腔感染、宫内残留胚胎组织、宫腔粘连发生率均明显低于常规组,差异均有统计学意义(P<0.05)。两组患者用药期间均未出现明显不良反应症状,且干预组术后3个月体质量增加量与常规组比较,差异均无统计学意义(P>0.05)。干预组术后6个月再妊娠率与常规组比较,差异无统计学意义(P>0.05),但干预组术后6个月再稽留流产率明显低于常规组,差异有统计学意义(P<0.05)。结论:稽留流产患者实施清宫术后口服避孕药可促进患者早日恢复,并减少并发症,降低再稽留流产风险,改善预后,且用药安全性高。

Objective:To investigate the clinical effect of oral contraceptive in patients with missed abortion after curettage.Method:80 patients with missed abortion were selected from January to December 2017 in our hospital.They were divided into routine group and intervention group according to the random number table method,40 cases in each group.Both groups were given routine curettage.After curettage,the routine group was treated with antibiotics and Yimucao,and the intervention group was treated with oral contraceptive(Drospirenone and Ethinylestradiol Tablets)on the basis of the routine group.The postoperative recovery,sex hormone level,postoperative complications,repregnancy and missed abortion at 6 months after curettage in the two groups were analyzed.Result:The duration of continuous vaginal bleeding and menstrual resuscitation in the intervention group were significantly shorter than those in the routine group,the differences were statistically significant(P<0.05).2 weeks after curettage,the endometrial thickness,estradiol in the intervention group were significantly higher than those in the routine group,while luteinizing hormone and progesterone in intervention group were lower than those in routine group,the differences were statistically significant(P<0.05).There was no significant difference in follicle stimulating hormone between two groups 2 weeks after curettage,the difference was no statistically significant(P>0.05).The incidence of pelvic infection,intrauterine residual embryo tissue and intrauterine adhesion in the intervention group were significantly lower than those in the routine group,the differences were statistically significant(P<0.05).There were no obvious adverse reaction symptoms in the two groups during the treatment period,and there was no significant difference between two groups in the increase of body mass 3 months after curettage,the differences were no statistically significant(P>0.05).6 months after curettage,there was no significant difference in the rate of re-pregnancy between two groups(P>0.05),but the rate of recurrent abortion in the intervention group was significantly lower than that in the routine group,the difference was statistically significant(P<0.05).Conclusion:Oral contraceptive in patients with missed abortion after curettage can promote early recovery,reduce complications,reduce the risk of recurrent abortion and improve prognosis,and the safety of medication is high.