不同黄体支持法对早期先兆流产及其妊娠结局影响  

Effect of different luteal support methods on early threatened abortion and pregnancy outcomes of women

作　　者：李燕[1] 李晓兰[1] 马俊旗[1] LI Yan;LI Xiaolan;MA Junqi(The First Affiliated Hospital of Xinjiang Medical University, Xinjiang, 83000)

机构地区：[1]新疆医科大学第一附属医院乌鲁木齐

出　　处：《中国计划生育学杂志》2020年第1期44-47,共4页Chinese Journal of Family Planning

基　　金：新疆维吾尔自治区自然科学基金(2017D01C319)

摘　　要：目的:探讨不同黄体支持法治疗早期先兆流产效果及对妊娠结局影响。方法:将90例早期先兆流产患者随机分为3组,肌注组(30例)采用肌注黄体酮针剂治疗,口服组(30例)采用口服地屈孕酮治疗,阴道用药组(30例)采用黄体酮软胶囊(安琪坦)阴道给药治疗。观察3组治疗前后血清孕酮(P)、雌二醇(E2)、人绒毛膜促性腺激素(hCG)水平差异,保胎成功率以及妊娠结局。结果:3组保胎成功率(70.0%、66.7%、76.7%)比较无差异,阴道出血时间(3.0±0.7d、3.2±0.4d、3.3±0.5d)比较无差异,围产期前置胎盘、胎盘早剥、胎膜早破并发症、妊娠至足月率、完全流产率、稽留流产率比较无差异(均P>0.05);治疗后P水平口服组最高,E2、hCG水平肌注组最高(均P<0.05)。结论:口服、肌注、阴道给药均有较好的保胎效果,对围产期并发症和妊娠结局无明显影响。肌注可提高治疗后血清E2、hCG水平,应首选。Objective:To investigate the effect of different luteal support methods on early threatened abortion,and to analyze its influence on pregnancy outcomes.Methods:90 women with early threatened abortion were randomly divided into three groups,which included group A(30 women treated by intramuscular progesterone injection),group B(30 women treated by oral dydrogesterone),and group C(30 women treated by vaginal progesterone soft capsule).The levels of serum progesterone(P),estradiol(E2)and human chorionic gonadotropin(hCG)of women in the three groups were observed before and after treatment,and the success rate of fetal protection and pregnancy outcomes of women in the three groups were also observed.Results:The success rate of women in the three groups were 70.0%,66.7%,and 76.7%,respectively,which had no significant different(P>0.05).The vaginal bleeding time of women in the three groups were 3.0±0.7d,3.2±0.4d,3.3±0.5d,respectively,which had also no significant different(P>0.05).There were no significant different in the rates of perinatal placenta previa,placental abruption,premature rupture of membranes,full-term pregnancy,complete abortion,and missed abortionof women among the three groups(P>0.05).After treatment,the P level of women in group B was highest,and the level of E2 or hCG of women in group A was highest(P<0.05).Conclusion:Intramuscular progesterone injection,oral dydrogesterone,and vaginal progesterone soft capsule have all significant effect on fetal protection,which have the same influence on perinatal complications and pregnancy outcomes.Intramuscular progesterone injection can increase the levels of E2 and hCG of women with early threatened abortion,so it can be considered for using firstly.

关 键 词：早期先兆流产 黄体支持 给药途径 妊娠结局 激素水平 

分 类 号：R71[医药卫生—妇产科学]