摘要
目的:探究雌二醇凝胶用于早期稽留流产术后子宫内膜修复的疗效及安全性。方法:选取2021年11月-2022年6月本院诊断为稽留流产并自愿要求行人工流产术的患者240例,随机数字表法分为空白组、对照组和观察组各80例,分别流产术后采用基础治疗、基础治疗联用屈螺酮炔雌醇(优思悦)、基础治疗联用雌二醇凝胶治疗,比较各组术后不同时期子宫内膜厚度、月经异常治疗效果、阴道流血时间、首次月经复潮时间、宫腔粘连、宫腔积液、盆腔炎性疾病、月经量减少、闭经及用药后不良反应,随访术后1年再次妊娠情况。结果:术后两周观察组子宫内膜厚度较高于对照组和空白组,治疗1周期、3周期时3组子宫内膜均变厚且观察组厚度(7.86±2.27mm、8.05±2.62mm)高于对照组(5.52±1.84mm、6.01±1.75mm)及空白组(4.92±1.53mm、5.07±1.62mm),对照组治疗3个周期后高于治疗1周期,空白组治疗3周期后高于术后两周(均P<0.05)。治疗月经异常疗效,观察组(93.8%)高于对照组(80.0%)及空白组(66.3%),观察组出现宫腔粘连、月经量减少、宫腔积液及盆腔炎性疾病比例更少,对照组阴道出血时间及月经复潮时间更短(P<0.05),而观察组与对照组治疗后出血闭经情况未见差异(P>0.05)。药物不良反应总发生率观察组(3.8%)与空白组(2.5%)无差异(P>0.05),但两组均低于对照组(15.0%)(P<0.05)。随访1年内失访观察组5例、对照组7例、空白组4例,术后1年内再次妊娠率及活胎率观察组(68.0%、88.2%)均高于对照组(39.7%、62.1%)及空白组(29.0%、59.1%)(均P<0.05)。结论:早期稽留流产术后应用雌二醇凝胶可有效促进患者子宫内膜修复,加速月经恢复,治疗月经异常疗效优于优思悦,减少术后并发症、宫腔粘连、阴道出血等发生,不良反应较少具有更高的安全性,有效预防远期不孕症的发生。
Objective:To investigate the efficacy and safety of estradiol gel for the endometrial repair of patients after the early missed abortion.Methods:240 patients with early missed abortion who wanted evacuation and curettage in the hospital were selected and were divided into three groups(80 cases in each group)by random number table methods from November 2021 to June 2022.The patients in group A were treated with basal therapy,the patients in group B were treated with basal therapy combined with drospirenone and ethinylestradiol tablets,and the patients in group C were treated with basal therapy combined with estradiol gel.The endometrial thickness at the postoperative different time points,the effect of the treatment of the abnormal menstruation,the duration of vaginal bleeding,the time of the first menstrual cycles restoration after abortion,the incidences of the intrauterine adhesion,the uterine cavity effusion,the pelvic inflammatory diseases,the decreased menstrual volume and the amenorrhoea,the adverse reactions rate and the pregnancy situation within l year of the postoperative follow-up of the patients were compared among the three groups.Results:The endometrial thickness of the patients in group C in two weeks after operation was significantly higher than that of the patients in group B and in group A.The endometrial thickness of the patients in the three groups after 1 cycle or 3 cycles of treatment had increased significantly,and which(7.86±2.27 mm or 8.05±2.62 mm)of the patients in group C was significantly higher than that(5.52±1.84 mm or 6.01±1.75 mm)of the patients in group B and that(4.92±1.53 mm or 5.07±1.62 mm)of the patients in group A.The endometrial thickness of the patients in group B after 3 cycles of treatment was significantly higher than that after 1 cycle of treatment,and which of the patients in group C after 3 cycles of treatment was significantly higher than that after 2 cycles of treatment(all P<0.05).The effective rate of the treatment of the abnormal menstruation(93.8%)of the p
作者
杜晓琴
张利容
勾卓君
董小菡
王佩厶
王亮
朱一平
陈丽娟
DU Xiaoqin;ZHANG Lirong;GOU Zhuojun;DONG Xiaohan;WANG Peisi;WANG Liang;ZHU Yiping;CHEN Lijuan(The Affiliated Mianyang Hospital of School of Medicine,University of Electronic Science and Technology,Mianyang Central Hospital,Mianyang,Sichuan Province,621000)
出处
《中国计划生育学杂志》
2024年第12期2739-2743,2749,共6页
Chinese Journal of Family Planning
基金
中国人口福利基金会妇幼关爱基金(FY202112010013)。
关键词
稽留流产术
雌二醇凝胶
屈螺酮炔雌醇
子宫内膜
月经
并发症
术后妊娠
Operation of missed abortion
Estradiol gel
Drospirenone and ethinylestradiol
Endometrium
Menstruation
Complication
Pregnancy after operation
