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宫腔镜下清宫术联合雌孕激素预防稽留流产患者术后宫腔粘连的临床观察
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| 篇名： | 宫腔镜下清宫术联合雌孕激素预防稽留流产患者术后宫腔粘连的临床观察 |
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| 摘要： | 目的：观察宫腔镜下清宫术联合雌孕激素预防稽留流产患者术后宫腔粘连的临床效果。方法：选取2014年6月－2016年6月在我院妇科就诊的稽留流产患者120例，按顺序编码随机分成观察组（60例）和对照组（60例）。观察组患者在术前口服戊酸雌二醇片3 mg，qd，共5 d；在宫腔镜下行清宫术；术后口服戊酸雌二醇片/戊酸雌二醇环丙孕酮片1片，qd，共21 d。对照组患者进行常规清宫术，围手术期不用雌孕激素。比较两组患者阴道流血时间、术后14 d子宫内膜厚度、术后3个月内月经量、宫腔粘连情况及不良反应。结果：观察组患者除术前服药期间有2例阴道流血量多达月经量、1例妊娠物自行排出者退出研究外，57例完成研究。观察组患者术后阴道流血时间为（3.2±1.1）d，对照组为（5.4±1.9）d；观察组患者子宫内膜厚度为（8.04±1.52）mm，对照组为（5.27±2.36）mm；观察组患者宫腔粘连发生率为3.5％（2/57），对照组为15％（9/60）。观察组上述指标均优于对照组（P＜0.05）。结论：宫腔镜下清宫术联合雌孕激素有助于减少稽留流产患者术后阴道流血、促进子宫内膜修复、预防宫腔粘连，从而保护女性的生殖功能。 |
| ABSTRACT： | OBJECTIVE： To study the clinical effects of curettage under hysteroscopy combined with estrogen and progesterone in preventing intrauterine adhesion after missed abortion. METHODS： A total of 120 patients receiving missed abortion selected from gynecology department of our hospital during Jun. 2014-Jun. 2016 were randomly divided into observation group （60 cases） and control group （60 cases） according to seguential coding. Observation group was given estradiol valerate 3 mg，qd， for 5 d in total， received curettage under hysteroscope， and was given Estradiol valerate tablet/Estradiol valerate cyproterone tablet one tablet，qd after surgery， for 21 d. Control group received routine curettage and didn’t take estrogen and progesterone during the perioperative period. The time of vaginal bleeding， endometrial thickness 14 d after surgery， the amout of vaginal bleeding with in 3 months after surgery， intrauterine adhesion， the occurrence of ADR were observed in 2 groups. RESULTS： In observation group， 57 cases completed the study except that 2 cases withdrew from the study due to the amount of vaginal bleeding as much as menstrual volume and 1 case withdrew from the study due to pregnancy tissue self-discharge. The duration of postoperative vaginal bleeding was （3.2±1.1） d in observation group and （5.4±1.9） d in control group. The endometrial thickness of observation group was （8.04±1.52） mm and that of control group was （5.27±2.36） mm； the incidence of intrauterine adhesion was 3.5％ in observation group （2/57） and 15％ in control group （9/60）. Above indexes of observation group were better than those of control group （P＜0.05）. CONCLUSIONS： Curettage under hysteroscope combined with estrogen and progesterone helps to reduce post-curettage vaginal bleeding， promote endometrial repair and prevent intrauterine adhesion so as to protect women’s reproductive ability. |
| 期刊： | 2018年第29卷第2期 |
| 作者： | 刘颖蔚，赵纯全，赵玲，邓幼林 |
| AUTHORS： | LIU Yingwei，ZHAO Chunquan，ZHAO Ling，DENG Youlin |
| 关键字： | 稽留流产；宫腔镜；清宫术；雌激素；孕激素；宫腔粘连 |
| KEYWORDS： | Missed abortion； Hysteroscopy； Curettage； Estrogen； Progesterone； Intrauterine adhesion |
| 阅读数： | 248 次 |
| 本月下载数： | 4 次 |
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