药物流产后持续阴道流血清宫时机的探讨

目的探讨药物流产后持续阴道流血产妇的清宫时机。方法为了解决药物流产后出血时间过长和失血量过多的问题,本研究对不同时机行清宫术的孕妇进行术后出血量、出血持续时间及并发症发生情况的对比研究。结果本文1210例接受药物流产的孕妇中完全流产者1015例,占83.88%(1015/1210),流产失败195例,占16.12%(195/1210);流产失败195例产妇均行清宫术,其中出血量大于月经量即行清宫术,留院8d后仍然未能排出孕囊并于当天即行清宫术60例(I组);药物流产后d8复诊时行清宫术85例(Ⅱ组);药物流产后d15复诊时行清宫术50例(Ⅲ组)。I组的出血量和出血持续时间明显低于Ⅱ组,而Ⅱ组的出血量和出血持续时间则明显低于Ⅲ组,差异有统计学意义(t=8.96、5.68,P均﹤0.05)。各组间比较差异有统计学意义(F=7.02,P﹤0.05)。I组产妇清宫术后宫内感染及尿HCG转阴时间≥15d者所占比例均明显高于Ⅱ组,而Ⅱ组的产妇清宫术后宫内感染及尿HCG转阴时间≥15d者所占比例均明显高于Ⅲ组,差异有统计学意义(χ2=7.86、4.11、6.94、4.57,P均﹤0.05)。各组间宫内感染及尿HCG转阴时间≥15d者所占比例比较差异有统计学意义(P﹤0.05);而3组间不全流产率相比较则差异无统计学意义(P﹥0.05)。结论在药物流产后根据出血量判断其中药物流产失败者,并应尽早行清宫手术,可以有效解除造成流血量过多和流血时间过长的原因,并大大降低药物流产并发症的发生机率,帮助孕妇迅速康复。

Exploration on the Persistent vaginal bleeding after drug abortion

OBJECTIVE To investigate the persistent vaginal bleeding after drug abortion in the timing of maternal. METHODS In order to solve the problem of bleeding after drug abortion time and blood loss over the issue. We compared the different of postoperative hemorrhage, bleeding duration and complications of pregnant women with different curettage. RESULTS Among 1 210 patients receiving the drug abortion, 1 015 pregnant women conducted complete abortion, and accounted for 83.88% (1 015 / 1 210). 195 cases showed failed abortion, and accounted for 16.12% (195 / 1 210); 195 cases with failure abortion underwent curettage, whose volume bleeding was greater than the volume of menstrual bleeding or uterine curettage. 60 cases still failed to discharge the gestational sac after hospital stay after 8D and received curettage (group I); 85 cases got curettage after drug abortion for 8D (group Ⅱ); 50 cases with drug abortion referral received curettage after 15d (group Ⅲ). The hemorrhagic amount and duration of group I was significantly lower than that in Ⅱ group, and hemorrhagic amount and duration of Ⅱ group was significantly lower than those in Ⅲ group, there was significant difference between the two groups ( t = 8.96, 5.68, P﹤0.05). There was significant difference between groups (F = 7.02, P﹤0.05). The intrauterine infection after maternal uterine curettage and urinary HCG negative time﹥15d of I group received maternal uterine curettage were significantly higher than those of Ⅱ group, and the intrauterine infection after maternal uterine curettage and urinary HCG negative time﹥15 of Ⅱ group were significantly higher than those of Ⅲ group, there was significant difference between them ( χ2 = 7.86, 4.11, 6.94, 4.57, P﹤0.05). The intrauterine infection and urinary HCG negative time ﹥15d proportion were significantly improved (P﹤0.05), and there was significant difference in the incomplete abortion rate of the three groups (P﹥0.05). CONCLUSION According to the amount of bleeding after drug abortion, we should perform drug abortion failure to relieve excessive bleeding and bleeding time, and greatly reduce the probability of drug abortion complications, and contribute to rapid recovery to help pregnant women.