戊酸雌二醇、米非司酮、米索前列醇联合清宫术治疗稽留流产临床效果  

Clinical effect of Estradiol Valerate,Mifepristone and Misoprostol combined with curettage in the treatment of missed abortion

作　　者：夏婕 季滢[1] 刘铭兰[1] XIA Jie;JI Ying;LIU Minglan(Department of Gynecology and Obstetrics,Rugao People’s Hospital,Jiangsu Province,Rugao226500,China)

机构地区：[1]江苏省如皋市人民医院妇产科,江苏如皋226500

出　　处：《中国医药导报》2020年第32期72-75,共4页China Medical Herald

基　　金：国家自然科学基金资助项目(81070492)。

摘　　要：目的观察戊酸雌二醇(补佳乐)联用米非司酮、米索前列醇与清宫术治疗稽留流产的临床效果。方法选取2017年10月—2019年12月于江苏省如皋市人民医院妇产科就诊治疗的稽留流产患者82例,按照不同治疗方法分为对照组40例和观察组42例。对照组采用米非司酮配伍米索前列醇序贯应用,观察组米非司酮和米索前列醇用法同对照组,清宫术术前3 d及术后第1天起予以补佳乐序贯治疗,两组均行清宫术。观察两组的清宫时间、术中出血量、术中扩宫棒顺利进入情况、术后阴道出血时间、月经复潮时间、再次清宫率和人流综合征发生率,术后3个月超声检查评估两组子宫内膜容受性,并观察两组卵巢储备功能。结果观察组清宫时间、术后阴道出血时间及月经复潮时间均短于对照组,术中出血量少于对照组,再次清宫及人工流产综合征发生率均低于对照组,差异均有统计学意义(P<0.05);两组7号扩宫棒顺利进入情况比较,差异无统计学意义(P>0.05)。术后3个月,观察组子宫内膜厚度厚于对照组,搏动指数及血流阻力指数均低于对照组,Salle评分高于对照组,差异均有统计学意义(P<0.05)。术后3个月,观察组血清黄体生成素、卵泡刺激素水平均低于对照组,抗缪勒管激素水平高于对照组,差异有统计学意义(P<0.05)。结论补佳乐联合米非司酮、米索前列醇与清宫术治疗稽留流产的临床效果显著,且能改善稽留流产患者子宫内膜容受性及卵巢储备功能。Objective To observe clinical effect of Estradiol Valerate(Progynova)combined with Mifepristone,Misoprostol and curettage in the treatment of missed abortion.Methods Eighty-two patients with missed abortion treated in Department of Gynecology and Obstetrics of Rugao People’s Hospital in Jiangsu Province from October 2017 to December 2019 were selected and divided into control group(40 cases)and observation group(42 cases)according to different treatment methods.Control group was treated with Mifepristone combined with Misoprostol in sequence,while observation group was treated with Mifepristone and Misoprostol in the same way as control group.The patients in both groups were treated with Progynova three days before and one day after operation.The time of uterine curettage,intraoperative blood loss,smooth entry of uterine dilator,postoperative vaginal bleeding time,menstrual recovery time,re-curettage rate and incidence of abortion syndrome were observed in two groups.Endometrial receptivity was evaluated by ultrasonography at three months after operation,and ovarian reserve function was observed.Results The time of curettage,postoperative vaginal bleeding and menstrual recovery time in observation group were shorter than those in control group,the amount of intraoperative blood loss in observation group was less than that in control group,the incidence of re-curettage and induced abortion syndrome in observation group were lower than those in control group,the differences were statistically significant(P<0.05).There was no significant difference in number seven uterine dilator entering smoothly between two groups(P>0.05).Three months after operation,the endometrial thickness of observation group was thicker than that of control group,the pulsatility index and blood flow resistance index of observation group were lower than those of control group,and Salle score of observation group was higher than that of control group(P<0.05).Three months after operation,the levels of serum luteinizing hormone and follicle sti

关 键 词：戊酸雌二醇 米非司酮 米索前列醇 稽留流产 卵巢储备功能 

分 类 号：R714.21[医药卫生—妇产科学]