孕早期终止妊娠发生不全药物流产的因素分析  

Factor analysis of incomplete medical abortion during early pregnancy

作　　者：王英巧 张琳[2] 楼帅 WANG Yingqiao;ZHANG Lin;LOU Shuai(Department of Gynecology,Jinhua Maternal and Child Health Care Hospital,Jinhua 321000,China;Department of Gynecology,Jinhua Municipal Central Hospital,Jinhua 321000,China)

机构地区：[1]金华市妇幼保健院妇科,浙江金华321000 [2]金华市中心医院妇科,浙江金华321000

出　　处：《健康研究》2025年第1期116-120,共5页Health Research

基　　金：浙江省卫生健康科技计划临床研究应用项目(2022KY1336)。

摘　　要：目的分析孕早期(孕周<70天)妇女采用米非司酮联合米索前列醇行药物流产14天后发生不全药物流产的影响因素,为临床减少不全药物流产的发生提供思路。方法收集因不全药物流产至我院住院行宫腔镜或清宫手术的患者共100例(观察组),收集同期在我院行药物流产成功的患者共50例(对照组),通过单因素和多因素分析探讨不全药物流产的临床影响因素。结果单因素分析结果显示,观察组中年龄≥35岁、妊娠囊最大径线>18 mm、清宫次数≥1次的占比高于对照组,既往药物流产≥1次的占比低于对照组,差异有统计学意义(P<0.05);多因素Logistic回归结果显示,既往药物流产≥1次为不全药物流产的保护因素(OR=0.209,95%CI:0.074~0.591,P=0.003),年龄≥35岁、妊娠囊最大径线>18 mm、清宫次数≥1次为不全药物流产的危险因素(均P<0.05)。结论不全药物流产的影响因素较多,临床医师应综合考虑相关因素,结合患者意愿,并加强随访,减少不全药物流产的发生。Objective To analyze the factors influencing the occurrence of incomplete medical abortion 14 days after administration of mifepristone combined with misoprostol in women undergoing early pregnancy termination(gestational age<70 days),and to provide ideas for reducing the occurrence of incomplete medical abortion in clinical practice.Methods A total of 100 patients admitted to our hospital for hysteroscopic surgery or uterine evacuation due to incomplete medical abortion were included in the observation group.Additionally,50 patients who successfully underwent medical abortion at our hospital during the same period were included in the control group.Univariate and multivariate analyses were conducted to explore the clinical factors affecting incomplete medical abortion.Results Univariate analysis revealed that the observation group had a higher proportion of patients aged≥35 years,with a maximum gestational sac diameter>18 mm,and with a history of curettage≥1 time compared to the control group;these differences were statistically significant(P<0.05).Multivariate Logistic regression analysis indicated that a history of≥1 previous medical abortion was a protective factor against incomplete medical abortion(OR=0.209,95%CI:0.074-0.591,P=0.003).The age≥35 years,a maximum gestational sac diameter>18 mm,and a history of curettage≥1 time were risk factors for incomplete medical abortion(all P<0.05).Conclusions Multiple factors influence the occurrence of incomplete medical abortion.Clinicians should comprehensively consider relevant factors,align with patient preferences,and enhance follow-up to reduce the incidence of incomplete medical abortion.

关 键 词：孕早期 不全药物流产 影响因素 

分 类 号：R453.9[医药卫生—治疗学]