人工流产术后组织残留行二次清宫的手术指征探讨  

THE OPERATION INDICATION OF SECONDARY UTERINE CURRETAGE ON REMNANTS AFTER INDUCED ABORTION

作　　者：张玉霞[1] 郑峥[1] 朱雷雷[1] 胡燕飞 熊军波 甘小清[1] 

机构地区：[1]南方医科大学附属深圳市妇幼保健院,广东深圳518028

出　　处：《现代医院》2013年第9期43-45,共3页Modern Hospitals

摘　　要：目的分析人工流产术后残留物有绒毛组织的相关因素,探讨人工流产术后组织残留行二次清宫的手术指征。方法选择65例因人工流产术后组织残留行二次清宫的患者,根据病理结果分为有绒毛组和无绒毛组,比较两组血HCG水平、超声测得的残留物大小、首次清宫孕周和两次清宫间隔时间有无统计学差异。绘制HCG预测残留物有无绒毛的ROC曲线。结果有绒毛组的HCG明显高于无绒毛组(p=0.009)。ROC曲线下面积为0.904,诊断阈值为173 UI/L,对应诊断敏感性和特异性分别为87.5%和81.6%。有绒毛组残留物大小平均为4.08 cm2,高于无绒毛组(p=0.002)。结论 HCG测量和超声能有效判断人工流产术后残留组织有无绒毛,HCG大于173 UI/L或残留物大于4 cm2是二次清宫的手术指征。Objective To analyze relative factors of villus tissue in residue after induced abortion, and to explore the operation indication of secondary uterine curettage on remnants after induced abortion. Methods 65 patients who were operated secondary uterine curettage with abortive remnants after induced abortion were selected, and divided into 2 groups according to the pathological findings, with one group had villus tissue and the other none. HCG （human chorionic gonadotrophin）levels of blood, the size of abortive remnants measured by ultrasonic diagnostic equipment, gestational ages on first uterine curettage, and intervals times between two uterine curettage were statistical compared. The ROC curve was drawn to predict villus whether retained on residue. Results The HCG level of villus group was obvious higher than that of group without villus （p = 0. 009 ）. The area of ROC curve was 0. 904. The threshold of diagnosis was 173 UI/L, corresponding to the sensitivity and specificity of diagnosis were 87. 5% and 81.6% respectively. The average of size of abortive remnants of villus group was 4.08 cm2 , higher than the group without villus（p = 0. 002）. Conclusion HCG levels of blood and the size of abortive remnants measured by ultrasonic diagnostic equipment could judge effectively villus whether or not retained in remnants after induced abortion. The level of HCG was larger than 173 UI/L or residue was greater than 4 cm2 were the operation indication of secondary uterine curettage.

关 键 词：人工流产 残留 促绒毛膜激素 超声 

分 类 号：R169.41[医药卫生—公共卫生与预防医学]