药物流产后清宫指征的探讨

To Inquire the Indication of Curettage in the Vaginal Bleeding after Drug Abortion

目的:探讨药物流产后阴道出血行清宫0术的指征。方法:122例妇女药流后第2天常规B超探查宫内组织物残留情况,将其随机分成2组:清宫组和未清官组。对2组妇女药流后阴道出血时间、转经时间、经期和月经量进行观察和比较。结果:药物流产后转经时间、经期和月经量2组间无明显差异。B超检查宫内中强回声最大横径≤15 mm,2组药流后持续阴道出血时间相似;宫腔内中强回声最大横径≥16mm,清宫组及未清宫组药物流产后阴道出血持续时间分别为11.5±5.0d及23.2±12.5d,差异显著。结论:药物流产后应常规B超检查宫腔内组织物残留情况,B超官腔内中强回声最大横径≤15 mm,不必常规清宫。B超宫腔内中强回声最大横径≥16mm,应及时清宫。

Objective: To inquire the indication of curettage in vaginal bleeding after drug abortion. Methods: Ultrasound was used to detect the intrauterine tissue remnant of 122 examples after drug abortion routinely. The patients were divided into two subgroups randomly, group A were undergone the curettage, group B without this process. Some indexes including the duration of vaginal bleeding, the time of menstruation recovery, duration of menstruation and blood flow were compared between two subgroups. Results: In terms of the timing of menstruation, duration of menstruation, and bleeding flow, there was no significant difference between two sub- groups. As for duration of vaginal bleeding after drug abortion, in the patients with an ultrasound revealing the maximum diameters of the high ultrasonic density less than 15mm, there was no statistical difference between two sub - groups. When the maximum diameters of the high ultrasonic density were over 16mm, significant difference was observed between two sub- groups, the duration of vaginal bleeding was much shorter in the curettaged subgroup. Conclusion: Ultrasound should be used to detect the intrauterine tissue remnant among patients undergone drug abortion routinely. If the maximum diameters of the high ultrasonic density intrauterine less than 15mm, the curettage is unnecessary, while timely curettage should be performed among the patients with maximum diameters of the high ultrasonic density over 16mm.