CAJ | 학술논문

目的：探讨戊酸雌二醇联合地屈孕酮在稽留流产清宫术后的应用效果。方法选择2010年1月~2013年12月就诊的120例稽留流产患者作为研究对象，随机分为研究组和对照组，研究组手术前给予米非司酮及米索前列醇，术后服用戊酸雌二醇及地屈孕酮；对照组手术前给予米非司酮及米索前列醇，术后未服用药物。比较两组的手术后阴道出血时间、术后第14天子宫内膜厚度、月经复潮时间、月经量减少发生率、组织物残留发生率、宫腔粘连状况，并追踪患者再次妊娠情况。结果研究组术后阴道出血时间较短，22例患者3 d内阴道出血即停止，对照组仅12例，差异有统计学意义(P<0.05)。研究组术后第14天子宫内膜厚度显著优于对照组，差异有统计学意义(P<0.05)。两组的月经复潮时间、月经量减少发生率比较，差异有统计学意义(P<0.05)。两组的组织物残留发生率比较，差异无统计学意义(P>0.05)。研究组轻度粘连发生率显著低于对照组，差异有统计学意义(P<0.05)。研究组再次成功妊娠9例，明显高于对照组的2例，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使用雌、孕激素，有利于促进子宫内膜生长，减少术后并发症，保护患者生殖功能。
목적：탐토무산자이순연합지굴잉동재계류유산청궁술후적응용효과。방법선택2010년1월~2013년12월취진적120례계류유산환자작위연구대상，수궤분위연구조화대조조，연구조수술전급여미비사동급미색전렬순，술후복용무산자이순급지굴잉동；대조조수술전급여미비사동급미색전렬순，술후미복용약물。비교량조적수술후음도출혈시간、술후제14천자궁내막후도、월경복조시간、월경량감소발생솔、조직물잔류발생솔、궁강점련상황，병추종환자재차임신정황。결과연구조술후음도출혈시간교단，22례환자3 d내음도출혈즉정지，대조조부12례，차이유통계학의의(P<0.05)。연구조술후제14천자궁내막후도현저우우대조조，차이유통계학의의(P<0.05)。량조적월경복조시간、월경량감소발생솔비교，차이유통계학의의(P<0.05)。량조적조직물잔류발생솔비교，차이무통계학의의(P>0.05)。연구조경도점련발생솔현저저우대조조，차이유통계학의의(P<0.05)。연구조재차성공임신9례，명현고우대조조적2례，차이유통계학의의(P<0.05)。결론계류유산환자실시청궁술후사용자、잉격소，유리우촉진자궁내막생장，감소술후병발증，보호환자생식공능。
Objective To investigate the application effects of estradiol valerate combined with dydrogestrone after curettage of missed abortion. Methods 120 cases with missed abortion from January 2010 to December 2013 were se-lected and randomly divided into the study group and the control group.The study group was given mifepristone and misoprostol before surgery and oral administration of estradiol valerate and dydrogesterone after surgery.The control group was given mifepristone and misoprostol before surgery,but was not given any medicine after surgery.Postoperative vaginal bleeding time,endometrial thickness in fourteenth day after surgery,menstruation recurrence time,postoperative menstrual blood volume,incidence of tissue residual and intrauterine adhesion status in two groups were compared,and re-pregnancy situation was traced. Results The postoperative vaginal bleeding time in study group was short and 22 patients stopped vaginal bleeding in 3 days,but only 12 patients stopped vaginal bleeding in 3 days in control group, with statistical difference (P<0.05).In the study group,the postoperative endometrial recovery situation was good and in fourteenth day after surgery,endometrial thickness in study group in fourteenth day after surgery was significantly better than that in control group,with statistical difference (P<0.05).Menstruation recurrence time and incidence of decreased menstrual bleeding volume between two groups was compared,with statistical difference (P<0.05).The incidence of mild adhesion in study group was significantly lower than that in control group,with statistical difference (P<0.05). The inci-dences of moderate adhesion between two groups was compared,with no statistical difference (P>0.05).Follow-up visit showed that 9 patients in study group were successfully pregnant and 2 patients in control group were successfully pregnant,with statistical difference (P<0.05). Conclusion The application of estrogen and progestin in patients with missed abortion curettage is conducive to promoting endometrial growth,reducing postoperative complications and pro-tecting the patients’reproductive function.