药物流产后阴道出血时间相关因素的定量研究

目的:了解影响药物流产后阴道出血时间的相关因素及其与出血时间的定量关系。方法:采用前瞻性的研究方法,共接纳合格妇女136人,对入选对象均进行全程随访。采用Cox回归,Kaplan-Meier方法进行分析。结果:11例因阴道出血时间过长(>14天)和(或)B超提示宫腔内组织物残留(平均径线>2.0cm)而行清宫术。Cox回归分析显示孕囊平均直径(GS)、药物流产后血β-hCG浓度及测定β-hCG的时间与药物流产后阴道出血时间有关。血β-hCG每增加1IU/L,持续出血的可能性为原来的1.0002倍;GS每增加1cm,持续出血的可能性为原来的1.596倍,按GS与药物流产后血β-hCG浓度分组比较,不同组之间药物流产后阴道出血时间有显著性差异(P<0.01)。结论:孕囊平均直径的大小对预测药物流产后阴道出血时间的作用较大,而药物流产后一次血β-hCG检测对预后的判断作用有限,有条件者应在流产前及流产后做血β-hCG动态测定,尤其是药物流产前血β-hCG的测定,对预测出血时间可能更有意义。停经天数不宜单独作为预测指标。

Quantitative Study on the Correlated Factors of the Duration of Vaginal Bleeding After Drug - induced Abortion

Objective: To find out the correlated factors of the duration of vaginal bleeding after drug - in-duced abortion and their quantitative relationships. Methods: 136 women were closely followed - up for the whole course by prospective study method. Cox regression and Kaplan - Meier analysis was used. Results: Curettage of the uterine cavity was performed in 11 cases due to prolonged duration of vaginal bleeding ( > 14 days) and/or intrauterine residuals showed by B - mode (mean diameter >2. Ocm). Cox regression analysis showed that mean diameter of gestational sac ( GS) , serum ### - hCG concentration after drug - induced abor-tion and the interval between blood - sampling and abortion were related to the duration of vaginal bleeding after drug - induced abortion. The possibility of continuing vaginal bleeding increased by 1. 0002 times if se-rum ### - hCG concentration increased 1 IU/L; while the possibility increased by 1. 596 times if GS increased 1 cm. There is significant difference between GS group and serum p - hCG concentration group (P < 0. 01). Conclusion: GS mean diameter is more effective for predicting the duration of vagina] bleeding after drug -induced abortion, while serum ### - hCG detection only once after drug - induced abortion is limited to predict . Re - examination of serum###p - hCG before and after abortion is recommended, which is more effective for predicting the duration of vaginal bleeding, especially for serum p - hCG before drug - induced abortion. Missed period should not be considered as an effective predictive index alone.