两种不同方法对于终止剖宫产术后1年内早孕患者的临床研究(1)
[摘要] 目的 探讨人工流产及药物流产对于终止剖宫产术后1年内早孕患者的疗效, 方法 随机选取2014年3月—2015年3月该院收治剖宫产术后1年内意外早孕(孕囊≤25 mm),要求终止妊娠的患者60例,按照不同的终止妊娠方法将患者分为人工流产组及药物流产组,每组例数均为30。 结果 药物流产组患者完全流产率为93.33%,明显高于人工流产组患者的76.67%,胎囊完全排出且无宫腔残留,宫口松,无人工流产综合征发生为完全流产,两组完全流产率比较,差异有统计学意义(P<0.05);两组患者胎囊排出时间、 阴道流血时间、 月经复潮时间、 阴道出血量,差异无统计学意义(P>0.05)。 结论 药物流产对于终止剖宫产术后1年内早孕患者,与人工流产相比,具有简便、安全、有效、不良反应小、患者痛苦小、身体恢复快等优点,值得临床推广。
[Abstract] Objective To discuss the curative effect of artificial abortion and drug abortion for the termination of patients with early pregnancy in one year after the cesarean section. Methods 60 cases of patients with early pregnancy by accident in one year after the cesarean section admitted in our hospital from March 2014 to March 2015 were collected (pregnant sac ≤25 mm)and requiring the termination of pregnancy were collected and divided into the artificial abortion group and the drug abortion group with 30 cases in each according to the different methods of termination of pregnancy. Results The complete abortion rate in the drug abortion group was obviously higher than that in the artificial abortion group, (93.33% vs 76.67%), the complete discharge of fetal sac and no residual of uterine cavity, cervical loose, no artificial abortion syndrome were complete abortion, the difference in the complete abortion rate between the two groups was statistically significant (P<0.05), the differences in the fetal sac discharge time, vaginal bleeding time, menstruation time and vaginal bleeding volume between the two groups were not statistically significant(P >0.05). Conclusion Compared with the artificial abortion, the drug abortion for the termination of patients with early pregnancy in one year after the cesarean section is easy, convenient, effective and has mild adverse reactions , and the patients have the advantages of less pain and quick physical recovery, which is worth promoting in clinic.
[Key words] In one year after cesarean section; Early pregnancy; Artificial abortion; Drug abortion
近几年剖宫产率逐年上升,瘢痕子宫妊娠率也随之升高,同时瘢痕子宫妊娠要求终止妊娠的患者也日益增多。尤其是术后1年以内妊娠,高危人流也相应增加[1],若行人工流产术,如何缩小手术难度, 减少手术时间, 减少并发症,控制子宫切口瘢痕部位妊娠流产时引起的大出血, 及避免子宫切除等问题,一直都是困扰妇产科医生难以解决的问题。为探讨安全有效终止剖宫产术后1年内早孕患者的方法,现将该院2014年3月—2015年3月收治剖宫产术后一年内意外早孕(孕囊≤25 mm),60例患者终止妊娠疗效,现报道如下。
1 资料与方法
1.1 一般资料
随机选取2014年3月—2015年3月该院收治剖宫产术后1年内意外早孕(孕囊≤25 mm),要求终止妊娠的患者内60例,根据孕妇病史结合孕妇意愿分为两组: 药流组30例, 人流组 30例。纳入标准:年龄 25~40岁, 孕龄≤49 d,彩超提示:孕囊≤25 mm,所有患者彩超诊诊为宫内早孕, 且除外胎囊位于子宫下段者; 相关化验如:心电图、凝血五项、血、尿、白带常规、肝肾功能、梅毒抗体及HIV检测均正常; 且对米非司酮、米索前列醇及人工流产无禁忌症,终止妊娠的育龄期妇女及家属均签署手术同意书,距离上次剖宫产时间半年至1年之间,患者的孕周、该次妊娠距离前次剖宫产的时间间隔、平均年龄、孕次等差异无统计学意义, 具有可比性。 (曲岩)
[Abstract] Objective To discuss the curative effect of artificial abortion and drug abortion for the termination of patients with early pregnancy in one year after the cesarean section. Methods 60 cases of patients with early pregnancy by accident in one year after the cesarean section admitted in our hospital from March 2014 to March 2015 were collected (pregnant sac ≤25 mm)and requiring the termination of pregnancy were collected and divided into the artificial abortion group and the drug abortion group with 30 cases in each according to the different methods of termination of pregnancy. Results The complete abortion rate in the drug abortion group was obviously higher than that in the artificial abortion group, (93.33% vs 76.67%), the complete discharge of fetal sac and no residual of uterine cavity, cervical loose, no artificial abortion syndrome were complete abortion, the difference in the complete abortion rate between the two groups was statistically significant (P<0.05), the differences in the fetal sac discharge time, vaginal bleeding time, menstruation time and vaginal bleeding volume between the two groups were not statistically significant(P >0.05). Conclusion Compared with the artificial abortion, the drug abortion for the termination of patients with early pregnancy in one year after the cesarean section is easy, convenient, effective and has mild adverse reactions , and the patients have the advantages of less pain and quick physical recovery, which is worth promoting in clinic.
[Key words] In one year after cesarean section; Early pregnancy; Artificial abortion; Drug abortion
近几年剖宫产率逐年上升,瘢痕子宫妊娠率也随之升高,同时瘢痕子宫妊娠要求终止妊娠的患者也日益增多。尤其是术后1年以内妊娠,高危人流也相应增加[1],若行人工流产术,如何缩小手术难度, 减少手术时间, 减少并发症,控制子宫切口瘢痕部位妊娠流产时引起的大出血, 及避免子宫切除等问题,一直都是困扰妇产科医生难以解决的问题。为探讨安全有效终止剖宫产术后1年内早孕患者的方法,现将该院2014年3月—2015年3月收治剖宫产术后一年内意外早孕(孕囊≤25 mm),60例患者终止妊娠疗效,现报道如下。
1 资料与方法
1.1 一般资料
随机选取2014年3月—2015年3月该院收治剖宫产术后1年内意外早孕(孕囊≤25 mm),要求终止妊娠的患者内60例,根据孕妇病史结合孕妇意愿分为两组: 药流组30例, 人流组 30例。纳入标准:年龄 25~40岁, 孕龄≤49 d,彩超提示:孕囊≤25 mm,所有患者彩超诊诊为宫内早孕, 且除外胎囊位于子宫下段者; 相关化验如:心电图、凝血五项、血、尿、白带常规、肝肾功能、梅毒抗体及HIV检测均正常; 且对米非司酮、米索前列醇及人工流产无禁忌症,终止妊娠的育龄期妇女及家属均签署手术同意书,距离上次剖宫产时间半年至1年之间,患者的孕周、该次妊娠距离前次剖宫产的时间间隔、平均年龄、孕次等差异无统计学意义, 具有可比性。 (曲岩)