不同浓度雌激素用于子宫纵膈术后对妊娠结局的影响  

Different dosages of progynova in TCRS under laparoscope effect on the pregnancy outcome

作　　者：邬欢欢[1] 易迎春[1] WU Huanhuan;YI Yingchun(Jiangxi Maternal and Child Health Hospital,Nanchang Jiangxi 330006,China)

机构地区：[1]江西省妇幼保健院,南昌330006

出　　处：《江西医药》2018年第7期657-659,共3页Jiangxi Medical Journal

基　　金：江西省卫生厅科技计划;编号20165471

摘　　要：目的研究不同浓度的雌激素用量对于纵膈术后患者妊娠结局的影响。方法选取江西省妇幼保健院2014年1月-2015年1月收治的80例子宫纵膈患者行腹腔镜监视子宫纵隔切除术(TCRS),设为对照组和观察组,观察组术后补充不同浓度雌激素治疗,随机分为四组,每组20例。并对五组患者的治疗效果进行对比分析。结果观察组患者术后宫腔残余纵膈和宫腔黏连情况与对照组无明显差异,P<0.05不具有统计学意义,与术后补充激素剂量无明显相关性。术后子宫内膜息肉增生情况随着雌激素用量的增加,患者人数明显增加,P>0.05与对照组相比差异明显,有统计学意义。在妊娠结局方面,实验组和对照组在自然妊娠率上均较术前显著提高,流产率明显下降,实验组的自然妊娠率高于对照组,流产率降低,两两比较P>0.05与对照组相比差异明显,无统计学意义。结论子宫纵膈术后患者应用雌激素治疗可有效减少术后宫腔黏连的复发,改善患者妊娠结局,但是不同剂量雌激素的补充对于患者术后疗效无明显差异。子宫纵膈切除术后患者应用雌激素治疗是必要的,但应给予患者最小有效剂量。Objective Research different concentrations of estrogen dosage for the effect of postoperative pregnancy outcome in patients with mediastinum, so as to seek effective drug concentration, for the prognosis of postoperative patients with mediastinal provides a standardized path. Methods January 2014 and January 2015 80 patients with uterine mediastinal laparoscopic moni-toring mediastinum uterus resection （TCRS）, set as control group and observation group, observation group added different concentration of estrogen therapy postoperatively, randomly divided into four groups, 20 cases in each group. And treatment effect of five groups of patients were analyzed. Results Observation group of patients with postoperative uterine cavity adhesion conditions caused by intrauterine residual mediastinal and no obvious difference with control group, P〈0.05 is not statistically significant, no obvious correlation with postoperative supplementary hormone doses. Endometrial polyps hyperplasia following surgery with an increase in the amount of estrogen, the number of patients increased significantly, P〉0.05 clear difference compared with control group, with statistical significance. In terms of pregnancy outcome, the experimental group and control group on preoperative significantly improve pregnancy rates in natural, abortion rate significantly decreased, natural pregnancy rate is higher than the control group, experimental group abortion rate is reduced, two more clear difference compared with control group （P〉0.05, no statistical significance. Conclusion Uterine postoperative patients with mediastinal used estrogen therapy can effectively reduce the relapse of postoperative uterine cavity adhesion, but can＇t significantly improve pregnancy outcome. Progynova is a safe and effective drug in improveing pregnant outcome after TCRS. But we must give the patient a minimal effective dose.

关 键 词：雌激素 剂量 子宫纵膈术 妊娠结局 

分 类 号：R713.4[医药卫生—妇产科学]