宫腔镜手术联合补佳乐配伍米非司酮治疗宫内妊娠物残留效果  

Efficacy of hysteroscopic surgery combined with progynova and mifepristone for treating patients with intrauterine pregnancy residual

作　　者：张蓓 陈云钗 冯继良 HANG Bei;CHEN Yunchai;FENG Jiliang(The Second Affiliated Hospital of Xiamen Medical College,Xiamen,Fujian Province,361000)

机构地区：[1]厦门医学院附属第二医院,361000

出　　处：《中国计划生育学杂志》2022年第12期2821-2824,共4页Chinese Journal of Family Planning

摘　　要：目的:探讨宫腔镜手术联合补佳乐配伍米非司酮治疗宫内妊娠物残留(IPR)的效果。方法:回顾性收集2020年1月-2021年12月本院收治的IPR患者65例临床资料,按手术方式的不同分组,吸宫组32例行彩超引导下直接吸宫术联合补佳乐配伍米非司酮治疗,宫腔镜组33例行宫腔镜下清宫术联合补佳乐配伍米非司酮治疗。比较两组手术指标、术后恢复情况、血人绒毛膜促性腺激素(HCG)、并发症、治愈率与再次干预率。结果:宫腔镜组宫腔镜组手术时长(10.1±2.5 min)及术中出血量(8.3±2.5 ml)均少于吸宫组,术后出血停止用时(8.8±1.2d)均短于吸宫组(7.1±1.0d),月经复潮时间(26.4±5.1d)、血HCG转阴时间(10.5±3.4d)均少于吸宫组(34.4±5.8d、14.3±3.7d),术后次日与术前的血HCG差值(441.01±22.47 IU/ml)大于吸宫组(367.29±26.75 IU/ml),术后宫腔粘连发生率(0)、并发症总发生率(3.0%)低于吸宫组(18.8%、25.0%),治愈率(100.0%)高于吸宫组(75.0%),再次干预率(0)低于吸宫组(25.0%)(均P<0.05)。结论:宫腔镜下清宫术联合补佳乐配伍米非司酮治疗IPR能缩短手术时长,减少术中出血,促进术后恢复,减少术后宫腔粘连发生率及再次干预率,提高治愈率且并发症更低。Objective:To investigate the efficacy of hysteroscopic surgery combined with progynova and mifepristone for treating patients with intrauterine pregnancy residual(IPR).Methods:The clinical data of 65 patients with IPR from January 2020 to December 2021 were collected retrospectively.These patients were divided into two groups according to the difference of surgical methods.32 patients in group A had been give uterine aspiration guided by ultrasound combined with progynova and mifepristone.33 patients in group B were treated with hysteroscopic curettage combined with progynova and mifepristone.The surgical indicators,the postoperative recovery situation,the blood human chorionic gonadotropin(HCG)level,the complications rate,the cure rate,and the re-intervention rate of the patients were compared between the two groups.Results:The operation duration(10.1±2.5 min)and intraoperative blood loss(8.3±2.5 ml)of the patients in group B were significantly shorter than those of the patients in group A.The time to stop postoperative bleeding(8.8±1.2d)of the patients in group B was significantly shorter than that(8.8±1.2 d)of the patients in group A.The time of menstruation recovery(26.4±5.1d)and the time of blood HCG turned to negative(10.5±3.4d)of the patients in group B were significantly lower than those(34.4±5.8d and 14.3±3.7d)of the patients in group A.The different level of blood HCG between 1 day after operation and before operation of the patients in group B(441.01±22.47 IU/ml)was significantly more than that(367.29±26.75 IU/ml)of the patients in group A.The incidences of postoperative intrauterine adhesion(0)and total complication rate(3.0%)of the patients in group B were significantly lower than those(18.8% and 25.0%)of the patients in group A.The cure rate(100.0%)of the patients in group B was significantly higher than that(75.0%)of the patients in group A,and the reintervention rate(0)of the patients in group B was significantly lower than that(25.0%)of the patients in group A(all P<0.05).Conclusion:Hys

关 键 词：宫内妊娠物残留 宫腔镜手术 补佳乐 米非司酮 复发 宫腔粘连 并发症 

分 类 号：R169.42[医药卫生—公共卫生与预防医学]