CAJ | 학술논문

目的：探讨剖宫产术后高危妊娠药物流产现状，及产后避孕的有效方法。方法回顾性分析2012年1月至2013年12月北京妇产医院150例住院行药物流产+B超下清宫术的剖宫产术后患者的临床资料。结果米非司酮配合卡前列甲酯流产成功率为98.0%，流产中平均出血量为（36.5±10.3）ml，平均住院时间为（4.3±1.2）d，无明显并发症发生。不同剖宫产次数患者文化程度及避孕情况的差异无统计学意义（P>0.05）；但不同剖宫产次数患者本次妊娠距离末次剖宫产时间的差异有统计学意义（P<0.01），1次剖宫产术后患者发生再次妊娠时间明显短于≥2次剖宫产术后患者。不同剖宫产次数患者再次妊娠流产时间的差异无统计学意义（P>0.05）；但不同剖宫产次数患者再次妊娠流产中出血量的差异有统计学意义（P<0.05），≥2次剖宫产术后再次妊娠患者流产中出血量明显增加。结论米非司酮配合卡前列甲酯结合B超下清宫术是终止剖宫产术后高危妊娠的有效方法；呼吁医疗机构大力宣传剖宫产术后避孕知识，落实科学有效的避孕方法。
목적：탐토부궁산술후고위임신약물유산현상，급산후피잉적유효방법。방법회고성분석2012년1월지2013년12월북경부산의원150례주원행약물유산+B초하청궁술적부궁산술후환자적림상자료。결과미비사동배합잡전렬갑지유산성공솔위98.0%，유산중평균출혈량위（36.5±10.3）ml，평균주원시간위（4.3±1.2）d，무명현병발증발생。불동부궁산차수환자문화정도급피잉정황적차이무통계학의의（P>0.05）；단불동부궁산차수환자본차임신거리말차부궁산시간적차이유통계학의의（P<0.01），1차부궁산술후환자발생재차임신시간명현단우≥2차부궁산술후환자。불동부궁산차수환자재차임신유산시간적차이무통계학의의（P>0.05）；단불동부궁산차수환자재차임신유산중출혈량적차이유통계학의의（P<0.05），≥2차부궁산술후재차임신환자유산중출혈량명현증가。결론미비사동배합잡전렬갑지결합B초하청궁술시종지부궁산술후고위임신적유효방법；호우의료궤구대력선전부궁산술후피잉지식，락실과학유효적피잉방법。
Objective To analyze the high risk induced abortion inpatients after caesarean section in Beijing Ob-stetrics and Gynecology Hospital, and understand the status in order to put forward the countermeasures and effective con-traception measures. Methods One hundred and fifty cases of re-pregnant women who were treated by induced abortion associated with curettages (uterine aspiration) guided by B mode ultrasound were analyzed retrospectively from Jan-uary, 2012 to December, 2013. Results The success rate of abortion using Mifepristone and Carboprost methylate was 98.0%, the average vaginal bleeding was (36.5±10.3)ml, the average days in hospital were (4.3±1.2)d without evident com-plications. No significant differences were observed among the number of caesarean sections and educational levels and contraception conditions (P>0.05), but there was significant differences between the number of caesarean sections and the interval from the last caesarean section (P<0.01). No evident differences were observed between the number of caesarean sections and the time of abortion (P>0.05), but there was significant differences between the number of caesarean sections and hemorrhage volume during abortion (P< 0.05). Conclusion Mifepristone and Carboprost methylate associated with curettages (uterine aspiration) guided by B mode ultrasound are effective to terminate high risk pregnancy after caesarean section. Medical institutions should vigorously promote contraceptive knowledge and implement safe and effective contra-ceptive measures after cesarean section.