早孕药物流产后阴道流血与宫腔修复的相关性分析  

An prospective observational study of the relationship between vaginal bleeding and uterine repair after medical abortion in early pregnancy

作　　者：吴彩林 王耀楷 邓善文 刘镭 胡端林 贾亦真 杜艳红 杨玉琪 曾胜 张丽 WU Cai-lin;WANG Yao-kai;DENG Shan-wen;LIU Lei;HU Duan-lin;JIA Yi-zhen;DU Yan-hong;YANG Yu-qi;ZENG Sheng;ZHANG Li(Department of Gynecology,The university of Hong Kong-shenzhen hospital)

机构地区：[1]香港大学深圳医院,广东深圳518048

出　　处：《中国妇幼保健》2024年第6期1059-1063,共5页Maternal and Child Health Care of China

基　　金：广东省医学科学技术研究基金项目(A2020265)。

摘　　要：目的 观察不同阴道流血时长的早孕药物流产患者,在流产后6周内的宫腔修复差异,并分析影响阴道流血的因素。方法 选取2021年1—12月香港大学深圳医院符合纳排标准的患者620例,收集其人口学等信息,于流产后3周、6周复诊。比较阴道流血≤3周组(A组)和>3周组(B组)宫腔修复差异并分析阴道流血的影响因素。结果 (1)A组在流产后3周及6周的宫腔修复率均比B组高(27.1%vs.4.2%;69.3%vs.56.4%),差异均有统计学意义(χ^(2)=57.94、10.48,均P<0.05)。B组在流产后3周宫腔修复率极低,但6周接近A组。(2)A组的大出血率小于B组(6.9%vs.12.2%),差异有统计学意义(χ^(2)=4.92,P<0.05),两组的盆腔感染率差异无统计学意义(1.6%vs.2.4%),差异无统计学意义(χ^(2)=0.48,P>0.05)。(3)经多因素分析,流产后3周的hCG值及残留物大小是阴道流血的影响因素(OR值均>1;P<0.05)。结论 (1)早孕药物流产后阴道流血时间短,宫腔修复早,延长随访时间,宫腔修复率显著增高。(2)阴道流血>3周组较≤3周组,盆腔感染率无差异,大出血风险稍增加。(3)流产后3周的hCG值及残留物大小是影响阴道流血时长的因素。Objective To observe the differences in uterine cavity repair in patients with early pregnancy with different vaginal bleeding duration within 6 weeks after abortion,and analyze the factors affecting vaginal bleeding.Methods 620 patients who met the standards in the University of Hong Kong Shenzhen Hospital were selected from January to December 2021,collected their demographic and other information,and returned to the clinic 3 weeks and 6 weeks after the abortion.Compare the differences in uterine repair between vaginal bleeding ≤ 3 week group(Group A) and > 3 week group(group B) and analyze the influencing factors of vaginal bleeding.Results The uterine repair rate of group A was higher than that of group B at 3 weeks and 6 weeks after abortion(27.1% vs.4.2%;69.3% vs.56.4%),the differences are statistically significant(all P<0.05).The repair rate of the uterine cavity in Group B was extremely low at 3 weeks after abortion,but it was close to Group A at 6 weeks.The bleeding rate of group A is less than that of group B(6.9% vs.12.2%),the difference is statistically significant(P<0.05),the difference in pelvic infection rate between the two groups is not statistically significant(1.6%vs.2.4%),the difference is not statistically significant(P>0.05).After multi-factor analysis,the hCG value and residue size 3 weeks after abortion are the influencing factors of vaginal bleeding(OR>1,P<0.05).Conclusion(1)After the early pregnancy medical abortion,the vaginal bleeding time is shorter.the speed of uterine cavity is repaired faster.Over time,the uterine cavity repair rate is significantly increased.(2)Bleeding > 3 week group,compared with the ≤ 3 week group,the pelvic infection rate was not different,and the risk of hemorrhage increased slightly.(3)The hCG value and residue size 3 weeks after abortion are the factors that affect the duration of vaginal bleeding.

关 键 词：药物流产 阴道流血 宫腔修复 

分 类 号：R169.42[医药卫生—公共卫生与预防医学]