先兆流产用药方案与保胎效果分析  

Analysis of Medication Scheme of Threatened Abortion and Effect of Fetal Preservation

作　　者：张会遵 ZHANG Huizun(Department of Obstetrics and Gynecology,Central Hospital of Huaxian County,Huaxian 456400,Henan,China)

机构地区：[1]河南省滑县中心医院妇产科,河南滑县456400

出　　处：《中国药物滥用防治杂志》2022年第6期727-731,共5页Chinese Journal of Drug Abuse Prevention and Treatment

摘　　要：目的:探究不同先兆流产用药方案的保胎效果。方法:选取2019年1月—2021年6月我院收治的先兆流产患者240例作为研究对象,依据随机数表法将其分为4组,每组60例。单药组采用地屈孕酮治疗,联合A组采用地屈孕酮联合低分子肝素钠治疗,联合B组采用地屈孕酮联合黄体酮治疗,联合C组采用地屈孕酮联合绒毛膜促性腺激素,比较四组症状改善情况、激素水平、保胎效果、妊娠结局及安全性。结果:联合A组、联合B组、联合C组阴道流血消失时间、孕酮恢复时间、腹痛缓解时间、腰痛缓解时间、宫缩消失时间短于单药组(P<0.05);联合A组、联合B组、联合C组雌二醇、孕激素诱导的阻断因子、孕酮、人绒毛膜促性腺激素水平优于单药组,联合C组优于联合A组、联合B组(P<0.05);联合C组、联合A组、联合B组保胎成功率高于单药组(P<0.05);四组妊娠结局比较,差异无统计学意义(P>0.05);联合A组、联合B组、联合C组呕吐、头晕、乏力、乳房肿胀、皮肤瘙痒不良反应发生率低于单药组(P<0.05)。结论:相较于地屈孕酮单药治疗,联合用药能显著缩短症状改善时间,提高保胎成功率,减少不良反应发生概率,且地屈孕酮联合绒毛膜促性腺激素可在上述基础上进一步平衡患者的激素水平。Objective:To explore the effect of different medication regimens for threatened abortion.Methods:A total of 240 patients with threatened abortion admitted to our hospital from January 2019 to June 2021 were selected and divided into 4 groups according to the random number table method,with 60 cases in each group.The single drug group was treated with dydrogesterone,the combined group A was treated with dydrogesterone combined with low molecular weight heparin sodium,the combined group B was treated with dydrogesterone combined with progesterone,and the combined group C was treated with dydrogesterone combined with chorionic gonadotropin.The improvement of symptoms,hormone levels,fetal protection effect,pregnancy outcome and safety of the four groups were compared.Results:The disappearance time of vaginal bleeding,progesterone recovery time,abdominal pain relief time,low back pain relief time and uterine contraction disappearance time in the combined group A,combined group B and combined group C were shorter than those in the single drug group(P<0.05).The levels of estradiol,progesterone-induced blocking factor,progesterone and human chorionic gonadotropin in the combined group A,combined group B and combined group C were better than those in the single drug group,and those in the combined group C was better than the combined group A and combined group B(P<0.05).The success rate of fetal protection in combined group C,combined group A and combined group B was higher than that in single drug group(P<0.05).There was no significant difference in pregnancy outcomes among the four groups(P>0.05).The incidence of adverse reactions such as vomiting,dizziness,fatigue,breast swelling and skin pruritus in combined group A,combined group B and combined group C was lower than that in the single drug group(P<0.05).Conclusion:Compared with dydrogesterone monotherapy,combination therapy can significantly shorten the time of symptom improvement,improve the success rate of fetal protection and reduce the incidence of adverse react

关 键 词：先兆流产 保胎 激素水平 地屈孕酮 绒毛膜促性腺激素 

分 类 号：R714.21[医药卫生—妇产科学]