人流后应用雌孕激素对胚物残留及宫腔粘连的疗效分析OA
Efficacy of estrogen and progesterone in preventing retained products of conception and intrauterine adhesions after induced abortion
目的 评估人工流产术后即时口服雌二醇片/雌二醇地屈孕酮片(每片含雌二醇2 mg)对降低胚物残留(RPOC)二次手术、预防宫腔粘连(IUA)及促进子宫内膜修复的临床疗效.方法 回顾性分析行人工流产术的494例患者,其中对照组214例,为术后仅常规服用抗生素及益母草颗粒者,观察组280例,在常规治疗基础上立即加用雌二醇片/雌二醇地屈孕酮片(每片含雌二醇2mg).比较两组患者在人工流产术后RPOC二次手术率、IUA发生率、术后子宫内膜厚度恢复情况、术后阴道出血持续时间、月经复潮时间和复潮月经量及术后并发症情况的差异.结果 观察组RPOC二次手术率为0.4％,低于对照组的2.3％,但组间差异无统计学意义(P=0.13,Fisher精确检验);观察组IUA发生率为1.8％,低于对照组的8.8％(P＜0.05);观察组术后2周子宫内膜厚度厚于对照组(P＜0.05);观察组术后阴道出血时间、月经复潮时间更短,术后盆腔感染、宫腔积液及月经量减少的发生率亦低于对照组,差异均有统计学意义(均P＜0.05).结论 人工流产术后立即口服雌二醇片/雌二醇地屈孕酮片可显著预防IUA、缩短术后阴道出血时间、促进内膜修复、改善月经恢复情况,并可能降低RPOC二次手术风险.
Objective To evaluate the efficacy of immediate postoperative oral administration of 2 mg estradiol/es-tradiol dydrogesterone tablets in reducing secondary surgery for retainedproducts of conception(RPOC),prevent-ing intrauterine adhesions(IUA),and promoting endometrial repair following induced abortion.Methods A retro-spective analysis was conducted on 494 patients who underwent induced abortion.The control group(n=214)re-ceived conventional postoperative treatment with antibiotics and Yimucao granules,while the observation group(n=280)received immediate administration of estradiol/dydrogesterone tablets(each tablet contains 2 mg of estra-diol),combined with antibiotics and Yimucao granules.The two groups were compared for the secondary surgery rate for RPOC,incidence of IUA,endometrial thickness at 2 weeks postoperatively,duration of postoperative vagi-nal bleeding,time to menstrual resumption,incidence of reduced menstrual volume after resumption,and postop-erative complications(pelvic infection,intrauterine fluid accumulation).Results The observation group showed a lower rate of secondary surgery for RPOC compared to the control group(0.4％vs 2.3％),but the difference was not statistically significant(P=0.13,Fisher's exact test).The observation group also had a significantly lower in-cidence of IUA(P＜0.05),greater postoperative endometrial thickness at 2 weeks(P＜0.05),and significantly shorter duration of postoperative vaginal bleeding and time to menstrual resumption.The incidence of reduced men-strual volume postoperatively and complications(pelvic infection,intrauterine fluid accumulation)were also sig-nificantly lower in the observation group(all P＜0.05).Conclusion Immediate oral administration of estradiol/dydrogesterone tablets after induced abortion significantly prevents intrauterine adhesions,shortens postoperative vaginal bleeding duration,promotes endometrial repair,improves menstrual recovery,and potentially reduces the risk of secondary surgery for retained products of conception.
谢迎艳;张李松;黄晓武;李晓雨;杨雪
首都医科大学附属复兴医院妇科,北京 100038首都医科大学附属复兴医院妇科,北京 100038首都医科大学附属复兴医院宫腔镜中心,北京 100038首都医科大学附属复兴医院妇科,北京 100038首都医科大学附属复兴医院宫腔镜中心,北京 100038
医药卫生
人工流产雌二醇片/雌二醇地屈孕酮片胚物残留子宫粘连子宫内膜修复月经恢复
induced abortionestradiol/dydrogesterone tabletsretained products of conceptionintrauterine ad-hesionsendometrial repairmenstrual recovery
《安徽医科大学学报》 2026 (7)
1277-1282,6
北京市教育委员会科研计划项目(编号:KM202410025009) R&D Program of Beijing Municipal Education Commission(No.KM202410025009)
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