几丁糖联合屈螺酮炔雌醇片对人工流产术后宫腔粘连的临床观察
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摘要
目的为了预防人工流产术后发生宫腔粘连,观察人工流产术后宫腔使用医用几丁糖联合口服屈螺酮炔雌醇片对术后宫腔粘连发生的预防效果。方法收集2015年8月~2017年10月来我院进行人工流产手术的400例患者,根据术后治疗方法的不同,分为A组(研究组)、B组(医用几丁糖组)、C组(屈螺酮炔雌醇片组)、D组(对照组),每组100例。A组宫腔内推注医用几丁糖联合口服屈螺酮炔雌醇片治疗,B组宫腔内推注医用几丁糖,C组口服屈螺酮炔雌醇片,D组术后口服抗生素和益母草颗粒,观察四组患者术后阴道出血情况、月经情况,比较四组人流术后宫腔粘连的临床效果。结果 A组月经量、阴道出血时间、首次月经复潮时间与B、C、D组相比,差异均具有统计学意义(P<0.05;A组宫腔粘连发生5例(5%)低于B13例(13%)、C18例(18%)、D25例(25%),差异均具有统计学意义(P<0.05)。结论医用几丁糖联合口服屈螺酮炔雌醇片可降低宫腔粘连发生机率,在临床上具有推广价值。
Objective: To investigate the efficacy of chitosan combined with drospirenone-ethinylestradiol tablets on prevention of intrauterine adhesion in patients after induced abortion. Methods: Totally, 400 patients undergoing induced abortion in our hospital from August 2015 to October 2017, were selected as the objects of study. They were divided into A group(test group), B group(chitosan group), C group(drospirenone-ethinylestradiol tablets group), and D group(control group) with 100 patients in each group. After induced abortion, patients in A group were treated with chitosan combined with drospirenone-ethinylestradiol tablets. Patients in B group were treated with chitosan. Patients in C group were treated with drospirenone-ethinylestradiol tablets. Patients in D group were treated with antibiotics combined with leonurus granules. Postoperatively, the vaginal bleeding, menstruation, intrauterine adhesion were compared among the four groups. Results: Compared with B,C,D group, patients in A group with the menstrual flow, shorten vaginal bleeding time, earliest time of first menses. There were 5 patients with intrauterine adhesion in A group(5%), 13 patients in B group(13%), 18 patients in C group(18%), and 25 patients in D group(25%)(P<0.05), with statistical significance. Conclusions: Chitosan combined with drospirenone-ethinylestradiol tablets can reduce intrauterine adhesion in patients after induced abortion, worth promoting.
Objective: To investigate the efficacy of chitosan combined with drospirenone-ethinylestradiol tablets on prevention of intrauterine adhesion in patients after induced abortion. Methods: Totally, 400 patients undergoing induced abortion in our hospital from August 2015 to October 2017, were selected as the objects of study. They were divided into A group(test group), B group(chitosan group), C group(drospirenone-ethinylestradiol tablets group), and D group(control group) with 100 patients in each group. After induced abortion, patients in A group were treated with chitosan combined with drospirenone-ethinylestradiol tablets. Patients in B group were treated with chitosan. Patients in C group were treated with drospirenone-ethinylestradiol tablets. Patients in D group were treated with antibiotics combined with leonurus granules. Postoperatively, the vaginal bleeding, menstruation, intrauterine adhesion were compared among the four groups. Results: Compared with B,C,D group, patients in A group with the menstrual flow, shorten vaginal bleeding time, earliest time of first menses. There were 5 patients with intrauterine adhesion in A group(5%), 13 patients in B group(13%), 18 patients in C group(18%), and 25 patients in D group(25%)(P<0.05), with statistical significance. Conclusions: Chitosan combined with drospirenone-ethinylestradiol tablets can reduce intrauterine adhesion in patients after induced abortion, worth promoting.
引文
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[6]范玉香,杜进巧,王志芹等.医用几丁糖预防剖宫产术后腹腔粘连临床观察[J].河北医药,2007,33(16):2448-2449.
[7]Juan Zhou,Clive Elson,Timothy D.G Lee.Reduction in postoperative adhesion formation and re-formation after an abdominal operation with the use of N,O-carboxymethyl chitosan[J].Surgery,2003,135(3).
[8]王莲莲,曹霞,罗希,施展.几丁糖和透明质酸钠防粘连材料在妇产科的应用[J].中国组织工程研究,2012,16(47):8923-8930.
[9]方玉,舒青青,陈洁瑛.流产后即时应用新型短效口服避孕药的临床观察[J].中国计划生育学杂志,2011,19(06):354-356.
[10]吕梅.屈螺酮炔雌醇片用于人工流产术后恢复治疗的临床观察[J].检验医学与临床,2013,10(09):1176-1177.
[11]Foidert JM,Wuttka W,Bouw GM,et al.A comparative investigation of contraceptive reliability cycle control and tolerance of two monophasic oral contraceptives containing either drospirenone or desogestrel[J].Eur J Contracept Reprod Health Care,2000,5:124-134.
[12]赵现立,刘朝阳,谭宏伟,张恩娣.屈螺酮炔雌醇片预防稽留流产清宫术后宫腔粘连初步研究[J].中国工程科学,2015,17(06):13-15+20.
[2]孙凤玲,党燕.人工流产术后应用屈螺酮炔雌醇片预防并发症的效果观察[J].宁夏医学杂志,2017,39(12):1187-1188.
[3]夏恩兰,宫腔镜学及图谱[M].河南科学技术出版社,2003.
[4]李蕾,奈嫚嫚,高桂香,王鲁文.几种预防人工流产术后宫腔粘连措施的疗效比较[J].中南大学学报(医学版),2016,41(09):975-978.
[5]成九梅,靳琳,夏恩兰,段华.雌孕激素受体及转化生长因子β_1在宫腔粘连发病机制中的作用[J].中国实用妇科与产科杂志,2005(09):539-541.
[6]范玉香,杜进巧,王志芹等.医用几丁糖预防剖宫产术后腹腔粘连临床观察[J].河北医药,2007,33(16):2448-2449.
[7]Juan Zhou,Clive Elson,Timothy D.G Lee.Reduction in postoperative adhesion formation and re-formation after an abdominal operation with the use of N,O-carboxymethyl chitosan[J].Surgery,2003,135(3).
[8]王莲莲,曹霞,罗希,施展.几丁糖和透明质酸钠防粘连材料在妇产科的应用[J].中国组织工程研究,2012,16(47):8923-8930.
[9]方玉,舒青青,陈洁瑛.流产后即时应用新型短效口服避孕药的临床观察[J].中国计划生育学杂志,2011,19(06):354-356.
[10]吕梅.屈螺酮炔雌醇片用于人工流产术后恢复治疗的临床观察[J].检验医学与临床,2013,10(09):1176-1177.
[11]Foidert JM,Wuttka W,Bouw GM,et al.A comparative investigation of contraceptive reliability cycle control and tolerance of two monophasic oral contraceptives containing either drospirenone or desogestrel[J].Eur J Contracept Reprod Health Care,2000,5:124-134.
[12]赵现立,刘朝阳,谭宏伟,张恩娣.屈螺酮炔雌醇片预防稽留流产清宫术后宫腔粘连初步研究[J].中国工程科学,2015,17(06):13-15+20.