稽留流产刮宫术后应用芬吗通或宫安康预防宫腔粘连的临床疗效观察  

Observation of the clinical efficacy of using Femoston or Gong'ankang for preventing intrauterine adhesion after curettage for missed abortion

作　　者：盛慧琳 陈勤芳[2] 赵欣 张琳 夏红 毕慧莉 王慧丽 华莹 周婷婷 SHENG Hui-lin;CHEN Qin-fang;ZHAO Xin(Department of Family Planning,Shanghai Putuo Maternity and Infant Health Center,Shanghai 200062,China.;不详)

机构地区：[1]上海市普陀区妇婴保健院计划生育科,上海200062 [2]上海交通大学附属国际和平妇幼保健院计划生育科,上海200030

出　　处：《医师在线》2024年第8期3-7,共5页Journal of Doctors Online

基　　金：上海市普陀区卫生健康系统科技创新项目(ptkwws202212)。

摘　　要：目的观察稽留流产刮宫术后应用芬吗通或宫安康预防宫腔粘连(IUA)的临床疗效。方法选取上海市普陀区妇婴保健院2022年6月~2023年2月因早期妊娠稽留流产行刮宫术的患者213例,采用随机数字表法分为3组,各71例,均在超声监护下行无痛刮宫术。术后,芬吗通组口服芬吗通预防IUA,宫安康组宫腔内注入宫安康预防IUA,对照组不做任何干预。分别比较三组患者刮宫术后阴道流血持续时间、术后2周子宫内膜厚度、月经复潮时间、IUA患病率、药物不良反应等发生情况。结果术后失访18例,最终对照组67例、芬吗通组63例、宫安康组65例完成研究。三组患者年龄、怀孕次数、流产次数、停经时间、文化程度等情况比较无显著差异(P>0.05)。宫安康组(4.62%)和芬吗通组(4.76%)术后3个月IUA患病率低于对照组(14.93%),三组比较差异有统计学意义(χ2=6.121,P=0.047<0.05)。与对照组[(7.96±4.64)d]相比,宫安康组和芬吗通组术后阴道流血持续时间更短,分别为[(6.49±3.70)d]和[(5.02±2.57)d](F=9.950,P<0.05)。术后2周子宫内膜厚度比较,芬吗通组[(6.95±3.61)mm]和宫安康组[(5.37±1.82)mm]厚于对照组[(4.96±2.11)mm](F=10.430,P<0.05)。月经复潮时间比较,宫安康组[(34.37±8.20)d]和芬吗通组[(32.02±7.99)d]短于对照组[(36.51±8.87)d],三组比较差异有统计学意义(F=4.670,P=0.010<0.05)。结论稽留流产刮宫术后应用芬吗通或宫安康,可有效促进子宫内膜修复,预防IUA。Objective To observe the clinical efficacy of using femoston or Gong'ankang for preventing intrauterine adhesion(IUA)after curettage for missed abortion.Methods A total of 213 patients who underwent curettage for missed abortion were selected from June 2022 to February 2023 in Shanghai Putuo Maternity and Infant Health Center.They were divided into femoston group,Gong'ankang group and control group according the random number table method,with 71 cases each.All patients underwent painless curettage under ultrasound guidance.After operation,the femoston group received oral femoston to prevent IUA,while the Gong'ankang group received intrauterine injection of Gong'ankang for the same purpose,and the control group received no intervention.The duration of postoperative vaginal bleeding,endometrial thickness two weeks after operation,menstrual recovery time,incidence of IUA,and occurrence of adverse drug reactions were compared among the groups.Results After operation,18 cases were lost to follow-up.Finally,67 cases in the control group,63 cases in the femoston group and 65 cases in the Gong'ankang group completed the study.There were no significant differences in age,number of pregnancies,number of abortions,menopause time and education level among the three groups(P>0.05).The prevalence of IUA after 3 months of operation was lower in the Gong'ankang group(4.62%)and the femoston group(4.76%)compared to the control group(14.93%),and the difference among the three groups was significant(χ2=6.121,P=0.047<0.05).Compared to the control group[(7.96±4.64)d],the duration of postoperative vaginal bleeding was shorter in the Gong'ankang group[(6.49±3.70)d]and the femoston group[(5.02±2.57)d](F=9.950,P<0.05).Two weeks after operation,the thickness of endometrial in the femoston group[(6.95±3.61)mm]and Gong'ankang group[(5.37±1.82)mm]was thicker than that in control group[(4.96±2.11)mm](F=10.430,P<0.05).The menstrual recovery time in the Gong'ankang group[(34.37±8.20)d]and femoston group[(32.02±7.99)d]was shorter than t

关 键 词：早期妊娠稽留流产 芬吗通 宫安康 宫腔粘连 

分 类 号：R711.74[医药卫生—妇产科学]