摘要
目的探讨戊酸雌二醇联合地屈孕酮预防流产后宫腔粘连效果及对性激素水平的影响。方法选择2018年1月至2019年10月于建德市第一人民医院接受人工流产手术患者142例,依据随机数字表法分为观察组71例与对照组71例。对照组患者术后给予促进子宫收缩及排淤血治疗,观察组患者在对照组基础上采用戊酸雌二醇片联合地屈孕酮片口服治疗。两组疗程均为3个月。比较两组出血时间、出血量和月经复潮时间,术后月经量情况,术前和术后3个月血清性激素水平变化,及术后12个月宫腔粘连发生情况。结果观察组术后出血时间[(4.35±0.97)d]、月经复潮时间[(24.83±1.43)d],均短于对照组[(5.67±1.14)d和(28.79±1.78)d],且出血量[(42.54±8.97)mL]少于对照组[(53.67±6.81)mL],差异均有统计学意义(t=7.431、14.614、8.327,均P<0.05)。观察组术后月经量正常(94.37%)多于对照组(81.69%)(χ2=5.413,P<0.05)。观察组术后3个月血清E2[(167.39±27.84)ng/L],高于对照组[(108.92±21.01)ng/L],而FSH[(17.83±3.27)IU/L、LH(28.98±7.63)IU/L]低于对照组[(26.54±4.58)IU/L、LH(49.83±13.54)IU/L],差异均有统计学意义(t=14.126、13.042、11.304,均P<0.05)。观察组术后12个月宫腔粘连发生率(2.82%)低于对照组(14.08%)(χ2=5.826,P<0.05)。结论戊酸雌二醇联合地屈孕酮预防流产后宫腔粘连效果良好,可有效减少术后出血量,降低宫腔粘连,改善患者术后月经量,改善患者性激素水平,值得临床借鉴。
Objective To investigate the effect of estradiol valerate combined with dydrogesterone on prevention of uterine adhesions after abortion and its influence on sex hormone level.Methods From January 2018 to October 2019,142 patients who underwent artificial abortion in the First People's Hospital of Jiande were divided into observation group(71 cases)and control group(71 cases)according to the random digital table mathod.The control group was given postoperative treatment to promote uterine contraction and congestion,and the observation group was given estradiol valerate tablets combined with dydrogesterone tablets on the basis of the control group.The course of treatment in both two groups was 3 months.The bleeding time,bleeding volume and menstrual rehydration time,menstrual volume after operation,the change of serum sex hormone level preoperation and postoperative 3 months,and the occurrence of intrauterine adhesions at 12 months after operation were compared between the two groups.Results The bleeding time[(4.35±0.97)d]and menstrual recovery time[(24.83±1.43)d]in the observation group were shorter than those in the control group[(5.67±1.14)d and(28.79±1.78)d],and the bleeding amount[(42.54±8.97)mL]in the observation group was less than that in the control group[(53.67±6.81)mL],the differences were statistically significant between the two groups(t=7.431,14.614,8.327,all P<0.05).The patients with normal amount of menstruation in the observation group(94.37%)was more than that in the control group(81.69%)(χ2=5.413,P<0.05).The serum E2 level[(167.39±27.84)ng/L]in the observation group was higher than that in the control group[(108.92±21.01)ng/L],while FSH[(17.83±3.27)IU/L]and LH[(28.98±7.63)IU/L]in the observation group were lower than those in the control group[(26.54±4.58)IU/L and(49.83±13.54)IU/L],the differences were statistically significant between the two groups(t=14.126,13.042,11.304,all P<0.05).The incidence of intrauterine adhesions in the observation group(2.82%)was lower than that in the control group(14.08%)(χ2=5.826,P<0.05).Conclusion Estradiol valerate combined with dydrogesterone has good effect on the prevention of postoperative uterine adhesions,which can effectively reduce the amount of postoperative bleeding,reduce the amount of postoperative uterine adhesions,improve the amount of menstruation and improve the level of sexual hormones of patients.It is worthy of clinical reference.
作者
朱彩红
孔建平
Zhu Caihong;Kong Jianping(Department of Obstetrics and Gynecology,the First People's Hospital of Jiande,Jiande,Zhejiang,311600,China)
出处
《中国基层医药》
CAS
2020年第17期2140-2144,共5页
Chinese Journal of Primary Medicine and Pharmacy
关键词
流产
人工
组织粘连
出血时间
月经周期
戊酸雌二醇
地屈孕酮
Abortion,induced
Tissue adhesions
Bleeding time
Menstrual cycle
Estradiol valerate
Didroxyprogesterone
