摘要
目的:分析人流不全的临床特点,探讨其发生的高危因素,同时调查患者术后的生育及避孕情况。方法:对首都医科大学附属北京妇产医院2007年10月—2012年10月收治的55例人流不全病历进行回顾性病例分析以及电话随访了解其生育情况及避孕情况。结果:人流不全的主要临床表现为人流术后的异常阴道出血42例(42/55,76.4%)以及月经异常13例(13/55,23.6%),超声检查可以发现人流不全造成的宫腔内异常,但需要结合人绒毛膜促性腺激素(HCG)水平的测定以及术后的病理来诊断人流不全。B超下的清宫手术能有效地清除残留的妊娠组织,术后均未再发现宫腔残留。人流不全的高危因素中主要的客观因素为子宫过度屈曲,占23.6%(13/55),主要的主观因素为宫颈扩张不够,占25.5%(14/55)。二次清宫术后主要并发症为宫腔粘连,发生率为5.5%(3/55)。55例患者术后共随访到29例患者,有17例再次妊娠,其中11例妊娠分娩,6例选择人工流产终止妊娠,未发现人流不全二次清宫对生育的明显不良影响。无生育要求的妇女均有意识采取避孕方法来避免意外妊娠。结论:人流不全的主要临床表现为手术后异常的阴道出血,通过结合尿或血的HCG检查以及B超检查,可以及时地发现人流不全。超声指导下清宫是治疗的有效办法。人流不全发生的高危因素,主要客观因素为子宫过度屈曲,主要主观因素为宫颈扩张不够。对于存在高危因素的手术采取超声指示下手术,能够有效地降低人流不全的发生率。人流不全二次清宫术后主要手术并发症为宫腔粘连,无手术并发症发生的患者,未发现明显生育能力的受损。但是对于避孕方法的选择,还需要更多的计划生育服务来帮助她们采取高效的避孕方法。
Objective：To analysis the clinical characteristics and high risk factors of incomplete abortion. In this study,the postoperative fertility is investigated. Method：55 cases of incomplete abortion that have been treated in Beijing obstetrics and Gynecology Hospital,Capital Medical University from October 2007 to October 2012 were investigated. At same time,we followed up these patients by telephone to collect information of their fertility status and contraceptive use. Result：The main clinical manifestations of incomplete abortion are abnormal vaginal bleeding in 42 cases（42/55,76.4 %）and abnormal menstruation in 13 cases（13/55,23.6 %）.Sonography is very useful to detect abnormal in the uterine cavity,but diagnosis of incomplete abortion requires the measurement of human chorionic gonadotropin（HCG）and postoperative pathology. The repeat curettage under the guide of B-sonograpy is effective. The main objective cause for incomplete abortion is excessive flexion of uterus,accounts for 23.6 %（13/55）. The main subjective factor is insufficient dilatation of cervix,accounts for 25.5 %（14/55）. The main complication of repeat curettage is intrauterine adhesions. The incidence is about 5.5 %（3/55）.There were 29 patients we could follow up. 17 cases have the history of pregnancy,11 cases have childbirth and 6 cases have artificial abortion to terminate pregnancy. Most of them use barrier contraceptive such as male condom to avoid unwanted pregnancy. Conclusion：The main clinical performance of incomplete abortion is abnormal vaginal bleeding after operation. The blood or urine HCG examination combined with ultrasonic examination can detect incomplete abortion timely. Repeat curettage under B- ultrasound guide is a effective treatment. The high risk factors of incomplete abortion include objective and subjective factors. The main objective factor is excessive flexion of uterus and the main subjective factor is insufficient dilatation of cervix. To reduce incidence of incomplete abortion,the oper
出处
《中国工程科学》
北大核心
2015年第6期70-76,共7页
Strategic Study of CAE
关键词
人流不全
并发症
宫腔粘连
生育
避孕
incomplete abortion
complication
intrauterine adhesion
fertility
contraception
