高危人工流产术后应用雌、孕激素预防宫腔粘连的临床观察

目的：研究高危人工流产术后使用雌、孕激素预防宫腔粘连的最佳方案.方法：选择妊娠＜ 14孕周行高危人工流产术妇女共600例,随机分成4组,每组150例.A组为早期序贯组,术后服用戊酸雌二醇1mg/d,共21d,后10d加服安宫黄体酮10mg/d;B组术后每日服用妈富隆1片（含乙炔雌二醇30μg、地索高诺酮150μg）,共21d;C组术后第14天开始服用戊酸雌二醇,1mg/d,共11d,后5d每日加服安宫黄体酮10mg;D组术后第14天开始服用妈富隆1片,1次/d,共11d.比较各组术后出血时间、术后3个月宫腔粘连情况.结果：宫腔粘连发生率A组（0.67％）与C组（10.00％）,B组（0.67％）与D组（8.67％）比较,差异均有统计学意义（P＜0.05）,术后出血时间A组（4.53±1.26d）与C组（7.12±0.85d）,B组（4.23±0.96d）与D组（8.03 ±1.12d）比较,差异均有统计学意义（P＜0.05）.结论：高危人工流产术后立即服用雌、孕激素预防宫腔粘连效果显著且可减少术后出血时间,值得临床应用.

Application of estrogen and progestational hormone in prevention of intrauterine adhesion after high-risk induced abortion

Objective：To explore the most appropriate method of applying estrogen and progestational hormone to prevent intrauterine adhesion after high-risk induced abortion.Methods：Six hundred women after high-risk induced abortion were randomly divided into 4 groups （150 cases each）.Women in group A received 1mg of estradiol valerate per day for 21 days after induced abortion,and 10mg of medroxyprogesterone acetate per day in last 10 days of estrogen intake.Women in group B were given one tablet of marvelon per day for 21 days after induced abortion.Women in group C received 1mg of estradiol valerate per day from the fourteenth to twenty-fifth day after induced abortion,and 10mg of medroxyprogesterone acetate per day in last 5 days of estrogen intake.Women in group D were given one tablet of marvelon per day for 11 days from the fourteenth day after induced abortion.The duration of vaginal bleeding and the incidence of the intrauterine adhesion were compared.Results：There were significant differences in the incidence of the intrauterine adhesion between group A （0.67％）and group C （10.00％） as well as group B （0.67％） and group D （8.67％,P all ＜ 0.05）.And there were significant differences in the duration of vaginal bleeding after induced abortion between group A （4.53 ± 1.26 days） and group C （7.12±0.85 days） as well as group B （4.23 ±0.96 days） and group D （8.03 ±1.12 days,Pall ＜0.05）.Conclusion：Immediate intake of estrogen and progestational hormone after high-risk induced abortion can significantly reduce the duration of vaginal bleeding and has significant effect of preventing intrauterine adhesion.