药物流产不全因素分析与清宫时机的探讨

目的：探讨药物流产不全相关因素与最佳清宫时机的选择。方法：对在本院的1296例药物流产不全行清宫术患者进行回顾性分析。结果：1296例清宫术后标本经病检为绒毛、蜕膜或机化坏死组织,部分伴炎性细胞浸润;屈位子宫较其他位置子宫药流不全率明显增高（P〈0.01）;药物流产不全率随年龄增大、胎产次增加和妊娠月份的增大而增高（P〈0.01）;有子宫手术史的药物流产不全率明显增高（P〈0.01）。结论：药物流产不全与子宫屈位、年龄、胎产次、妊娠天数、子宫手术史有密切关系。药物流产不全以出血为首要症状,为绒毛、蜕膜和（或）坏死机化组织残留所致;流血时间长并发感染率高,建议出血超过10d者,结合B超检查及时清宫,防止药物流产后并发症的发生。

Research on the factors of drug induced incomplete abortion insufficiency and time of uterus curettage

Objective： To study the related factors of drug induced incomplete abortion and the best time of uterus curettage. Methods： Retrospective analysis on 1 296 patients who took uterus curettage after incomplete medical abortion. Results： Through pathologic examination, the postoperative specimens of 1 296 cases were villi, decidua or organization of necrotic tissue, some of them were with inflammatory cells infiltration; The drugs abortion insufficiency of flexion uterus was significantly higher than other positions′ uterus （P0.01）; The rate of drug induced incomplete abortion increased with the age, the parity and the month of pregnancy （P0.01）; The rate of drug induced incomplete abortion of the patients with uterine surgery history were significantly higher （P0.01）. Conclusion： The rate of drug induced incomplete abortion is closely related to the uterine flexion, the age, the parity, the gestational days, and the uterus surgical history. The primary symptom of drug induced incomplete abortion is bleeding, which is caused by remnant of villi, decidua, or organization of necrotic tissue; long time blooding coincidenced high rate of infection. So it is recommended that the patients with more than 10 days bleeding should take the uterus curettage in time, combining with the B-ultrasonic examination, to prevent the occur rence of complications after drug abortion.