雌孕激素聯用對于藥物流產后陰道出血的療效及對激素水平的影響分析

林雪完 江超

【摘要】目的：探討雌-孕激素序貫治療藥物流產后陰道出血的臨床效果及對患者激素水平的影響分析。方法：采用隨機數字表法將本院收治的87例行藥物流產者隨機分為雌孕激素組44例和對照組43例，兩組均常規止血、消炎治療，雌孕激素組加用雌孕激素治療，觀察兩組患者的出血時間、出血量、流產結局及體內激素水平等指標的變化情況差異。結果：雌孕激素組患者的引導出血量少量的比例63.64%顯著的高于對照組的32.56%，雌孕激素組的出血量、出血時間顯著的低于對照組（P<0.05）。兩組患者在藥流當天的E2、P水平差異不顯著（P>0.05），7d后兩組的E2均顯著的增高、P顯著的降低（P<0.05），雌孕激素組患者的E2均顯著的增高、P顯著的降低效果優于對照組（P<0.05）。兩組患者在藥流當天的E2、P水平差異不顯著（P>0.05），7d后兩組的E2均顯著的增高、P顯著的降低（P<0.05），雌孕激素組患者的E2均顯著的增高、P顯著的降低效果優于對照組（P<0.05）。雌孕激素組與對照組的完全流產率比較差異不具有統計學意義（P>0.05）。結論：雌-孕激素序貫治療藥物流產后陰道出血能顯著的縮短出血時間、促進月經復潮、激素水平恢復。

【關鍵詞】雌-孕激素；藥物流產；陰道出血；臨床效果

Effect of joint use of estrogen and progesterone on vaginal bleeding after drug abortion and hormone levelsLIN Xuewan1， JIANG Chao2. 1. Department of Obstetrics and Gynecology， Haikou Third Peoples Hospital， Haikou 571100， Hainan， China； 2. Department of Obstetrics and Gynecology， The Hospital Affiliated to Hainan MedicalCollege， Haikou 571100， Hainan， China

【Abstract】Objectives： To analyze the clinical effect of joint use of estrogen and progesterone on vaginal bleeding after drug abortion and hormone levels in patients. Methods： 87 patients receiving drug abortion were randomly divided into estrogen and progesterone group （44 cases） and control group （43 cases）. Both groups were treated with conventional hemostasis and anti-inflammatory therapy. The estrogen and progesterone group was additionally treated with hormone therapy. The difference in bleeding time， bleeding quantity change， abortion outcome and hormone the level of the two groups was observed. Results： The proportion of patients with little bleeding amount in estrogen and progesterone group was 63.64%， higher than that of the control group （32.56%）； the amount of bleeding and bleeding time of estradiol and progesterone group was significantly lower than that of the control group （P<0.05）. Difference in E2 and P level between the two groups was not significant （P>0.05）， and 7d later the E2 of the two groups significantly increased while P levels decreased significantly （P<0.05）， more significant in estradiol and progesterone group than the control group （P<0.05）. Difference in the complete abortion rate between estradiol and progesterone group and control group was not statistically significant （P>0.05）. Conclusions： Estrogen and progestogen sequential therapy in the treatment of vaginal bleeding after drug abortion can significantly shorten the bleeding time， menstruation， hormone levels and promote the recovery.

【Key words】Estrogen and progesterone； Drug abortion； Vaginal bleeding； Clinical effect

【中圖分類號】R719.3+1【文獻標志碼】A

近年來婦科門診特別是計劃生育門診病人中，因宮內早孕或者稽留流產而進行人流的患者數量一直居高不下，對于停經月份較小的患者普遍采用米非司酮聯合米索前列醇藥流，而藥流術后月經量減少以及月經不調等癥狀越來越困擾婦科內分泌科醫生[1]。多數學者認為藥流過程中胚胎組織過度剝脫而損傷子宮內膜的情況，或者部分絨毛膜組織剝脫不全，均可能導致患者藥流術后月經量以及月經周期改變，甚至出現部分患者藥流術后3個月內月經不來潮[2，3]。本研究通過對于戊酸雌二醇聯合孕激素聯合序貫療法預防藥流術后相關月經失調的療效，來揭示雌孕激素聯合序貫療法的價值。……