稽留流产刮宫术后宫腔粘连的防治方法探讨

目的探讨稽留流产刮宫术后宫腔粘连的防治方法。方法选择稽留流产患者共300例,随机分为两组:研究组160例,刮宫术前使用米非司酮配伍米索前列醇,术后服用妈富隆片1片;对照组140例,手术前后无服药。观察两组手术时间、出血量以及术后月经变化。结果研究组患者手术时间和出血量为(4.1±1.8)min、(16.1±9.4)ml,分别较对照组的(7.9±2.3)min、(37.3±13.6)ml短或少,差异有统计学意义(P<0.05);术后阴道流血时间和流血量为(4.68±1.21)d、(43.5±12.6)ml,分别较对照组的(7.65±1.23)d、(57.3±13.4)ml短或少,差异有统计学意义(P<0.05);月经复潮时间较对照组早,轻、中度宫腔粘连发生较对照组少,差异均有统计学意义(P<0.05)。结论稽留流产患者刮宫术前使用米非司酮配伍米索前列醇,术后服用妈富隆,可有效预防宫腔粘连的发生。

Prevention of intrauterine adhesions after curettage surgery in patients with missed abortion

Objective To evaluate the method of prevention of intrauterine adhesions after curettage surgery in patients with missed abortion. Methods 300 patients with missed abortion were randomly divided into two groups. 160 patients of the test group were given Mifepristone and Misoprostol before curettage surgery. And Marvelon was given immediately after surgery. Then Marvelon was prescribed for 21 days and stopped for 7 days as a course; a complete treatment included 3 courses. 140 patients in the control group did not receive any treatment before or after surgery. The change of operation time,the mount of vaginal bleeding and menstruation were compared between the two groups. Results The operation time of the test group was significantly shorter than the control group (P<0.05). Duration of vaginal bleeding in the test group was significantly shorter than the control group (P<0.05). The amount of bleeding in the test group was less than the control group(P<0.05). Patients in the test group resumed menstruation earlier than the control group(P<0.05). The incidence of intrauterine adhesions in the test group was less than the control group(P<0.05). Conclusion Intrauterine adhesions could be prevented by using Mifepristone and Misoprostol before curettage surgery,and marvelon after surgery in patients with missed abortion.