早期葡萄胎清宫术后口服避孕药与避孕套避孕的临床效果比较  

Comparison of the clinical effect of oral contraceptive and condom used after uterine curettage of early hydatidiform mole

作　　者：王立娟 韩梅 WANG Lijuan;HAN Mei(Tongzhou Maternal and Child Health Care Hospital,Beijing,101100)

机构地区：[1]北京市通州区妇幼保健院,101100

出　　处：《中国计划生育学杂志》2022年第3期618-621,共4页Chinese Journal of Family Planning

基　　金：2018-2020年通州区卫生发展科研项目(TFZXPT-20180108)。

摘　　要：目的:探讨早期葡萄胎清宫术后采用不同避孕方式效果。方法:回顾性选择2017年10月-2019年4月本院行早期葡萄胎清宫术后患者106例临床资料,按不同避孕方式分为两组各53例,清宫术后分别采用避孕套避孕或即时开始口服短效口服避孕药(屈螺酮炔雌醇片)避孕。观察两组术后血清绒毛膜促性腺激素(HCG)下降情况、月经恢复情况、避孕效果。结果:术后避孕套组HCG值下降速度高于避孕药组,7周后两组无差别;术后两组月经周期缩短、无改变以及经量变化两组无差异(P>0.05),避孕药组阴道出血时间、月经恢复时间、周期延长、术后3周子宫内膜厚度优于避孕套组,避孕有效率(92.5%)高于避孕套组(77.4%),恶变、意外妊娠、复发、胎停育等总发生率(22.6%)低于避孕套组(7.5%)(均P<0.05)。结论:早期葡萄胎清宫术后及时口服避孕药避孕效果更佳,可减少葡萄胎复发率,提高预后安全性。Objective:To investigate the contraceptive efficacy of different contraceptive ued after uterine curettage of early hydatidiform mole.Methods:The clinical data of 106 patients who had accepted curettage of early hydatidiform mole from October 2017 to April 2019 were selected as the research objects retrospectively.These patients were divided into two groups(53 cases in each group)according to different contraceptive used after uterine curettage.The patients in group A were treated with drospirenone and ethinyl estradiol tablets immediately on the day of curettage,and the patients in group B were treated with condom.The situations of blood human chorionic gonadotropin(HCG)level decreasing and menstrual recovery,and contraceptive effect of the patients in the two groups were observed.Results:The rate of the decreasing of HCG level of the patients in group B was significantly higher than that of the patients in group A,but there was no significant difference in the HCG level of the patients in the 7 th week after surgery between the two groups.There were no significant differences in the rates of menstrual cycle shortening or no change,and the menstrual volume of the patients after surgery between the two groups(P>0.05).The vaginal bleeding duration,the menstrual recovery time,the rate of prolonged menstrual cycle of the patients after surgery,and the endometrial thickness of the patients in the 3 rd week after surgery in group A were significantly better than those in group B(P<0.05).The contraceptive effective rate(92.5%)of the patients in group A was significantly higher than that(77.4%)of the patients in group B,and the incidence of complication(22.6%),such as malignant transformation,unintended pregnancy,recurrence,and arrested fetal development,of the patients was significantly lower than that(7.5%)of the patients in group B(all P<0.05).Conclusion:The timely oral contraceptive of the patients after uterine curettage of early hydatidiform mole has reliable contraceptive effect,which can reduce their recurrence

关 键 词：早期葡萄胎清宫术 术后避孕 避孕套 口服避孕药 效果 安全性 

分 类 号：R169.41[医药卫生—公共卫生与预防医学] R737.33