雌孕激素治疗药物流产后阴道出血的效果分析  

The treatment effect of estrogen and progesterone on vaginal bleeding after medical abortion

作　　者：祝栋 

机构地区：[1]浙江省慈溪市第三人民医院妇产科,315324

出　　处：《中国计划生育学杂志》2013年第9期614-617,共4页Chinese Journal of Family Planning

摘　　要：目的:探讨雌孕激素联用对改善药物流产后阴道出血的临床效果,并对机体孕酮(P)与雌二醇(E_2)水平与流产结局的相关进行分析。方法:将85例行药物流产者随机分为口服复方短效避孕药(COC)组30例,雌孕激素联用(E+P)组28例,常规消炎、止血剂组(对照组)27例。对比分析3组出血量、出血时间以及药物流产结局与雌孕激素水平的关系。结果:E+P组出血量低于COC组及对照组,出血时间、转经时间短于COC组及对照组(P均<0.05);而COC组与对照组相比出血量、出血时间、转经时间无统计学差异(P>0.05)。完全流产率E+P组(100.0%)、COC组(90.0%)高于对照组(77.78%)(P<0.05)。与不完全流产组相比,完全流产组术后14d时E_2水平高于术后7d(P<0.05),而术后21d时P水平与14d相比显著上升(P<0.05)。不完全药流组E_2水平各时段无统计学差异(P>0.05),而术后14d时P水平低于术后7d(P<0.05)。结论:药物流产后所致的雌孕激素水平下降可能是引起妇女流产后持续出血的重要因素之一,通过改善药物流产者雌孕激素水平能提高流产成功率,缩短出血时间,减少出血量。Objective：To investigate the clinical effect of estrogen and progesterone on vaginal bleeding after medical abortion and relationships between abortion-related outcomes and levels of progesterone （P） and estradiol （E2）.Methods：A total of 85 women seeking for the routine medical abortion were randomly divided into recurrent short-acting oral contraceptives （COC） group （n =30）,estrogen and progesterone combination group （E ＋ P） group （n =28）,hemostatic agent group （control group,n =27）.The amount of vaginal bleeding,the duration of vaginal bleeding and relationships between abortion-related outcomes and levels of P and E2 were evaluated.Results：The amount of vaginal bleeding of E ＋ P group was lower than those of COC group and the control group,and both the duration of the vaginal bleeding and the interval between medical abortion and menstruation retrieve of E ＋ P group were shorter than those of latter two groups （P all ＜ 0.05）.While there were no significant differences in the amount of vaginal bleeding,the duration of vaginal bleeding,and the interval between medical abortion and menstruation retrieve between COC group and the control group （P ＞ 0.05）.The complete abortion rate of E ＋ P group （100.0％） and COC group （90.0％） were significantly higher than that of the control group （77.78％）.After the treatment,the E2 level of the complete abortion group on the 14th day was significantly higher than that on the 7th day （P ＜ 0.05）,and the P level on the 14th day was significantly lower than that on the 21st day （P ＜ 0.05）.In the incomplete group E2 levels at different times were not significantly different （P＞ 0.05）,while the P level on the 14th day after the treatment was significantly lower than that on the 7th day （P ＜ 0.05）.Conclusion：In the medical abortion,the decline of estrogen and progesterone levels may be one of important factors of continuous vaginal bleeding after abortion.The higher rate of the complete ab

关 键 词：药物流产 雌孕激素 疗效 

分 类 号：R169.42[医药卫生—公共卫生与预防医学]