瘢痕子宫与正常子宫早孕流产近期疗效比较研究

发布时间：2018-12-31 12:39

【摘要】：目的:探讨子宫瘢痕对早孕流产的影响,为瘢痕子宫早孕寻求安全有效流产方法。方法:选取2015年6月~2016年10月宁波大学附属阳明医院计划生育门诊和病房药物流产(以下简称药流)或负压吸引术(以下简称负吸术)或药流联合负吸术三种方法终止早孕的588例妇女为研究对象,其中瘢痕子宫早孕291例,药流、负吸术及药流联合负吸术各97例;正常子宫早孕297例,药流、负吸术及药流联合负吸术各99例。观察两组三种不同流产方法的完全流产率、不全流产率、流产失败率、妊娠物排出时间、出血量、阴道流血时间、人流综合反应发生率、子宫穿孔率、感染率等情况。结果:两组三种不同流产方法均无子宫穿孔发生;药流无人流综合反应发生。三种不同流产方法显示瘢痕子宫组较正常子宫组完全流产率低,不全流产率和流产失败率高,妊娠物排出慢,出血量多,阴道流血时间长,感染率高,但差异均无统计学意义(P0.05)。药流终止瘢痕子宫早孕较负吸术或药流联合负吸术完全流产率低,不全流产率和流产失败率高,妊娠物排出慢,出血量多,阴道流血时间长,感染率高,差异均有统计学意义(P0.05);药流联合负吸术终止瘢痕子宫早孕较负吸术妊娠物排出快,出血量少,阴道流血时间短,人流综合反应发生率及感染率低,差异均有统计学意义(P0.05),其余观察指标差异无统计学意义(P0.05)。结论:子宫瘢痕降低完全流产率,增加不全流产和流产失败率、出血量和流血时间及流产后感染发生率。药流联合负吸术终止瘢痕子宫早孕流产效果可靠,出血量少,阴道流血时间短,减少手术操作时间,降低子宫穿孔风险及感染发生率,是终止瘢痕子宫早孕安全有效的方法。
[Abstract]:Objective: to explore the effect of uterine scar on early pregnancy and to find a safe and effective method for early pregnancy. Methods: from June 2015 to October 2016, three prescriptions of drug abortion (hereinafter referred to as drug abortion) or negative pressure suction (hereinafter referred to as negative suction) or combination of drug flow and negative suction were selected in the family planning clinic and ward of Yangming Hospital affiliated to Ningbo University. 588 women who had terminated their early pregnancy were studied. There were 291 cases of early pregnancy with scar uterus, 97 cases of drug flow, 97 cases of negative suction and 97 cases of combined negative aspiration. There were 297 cases of normal early pregnancy, 99 cases of drug flow, 99 cases of negative suction and 99 cases of combined negative aspiration. The complete abortion rate, incomplete abortion rate, abortion failure rate, pregnancy excretion time, bleeding volume, vaginal bleeding time, rate of synthetic reaction of abortion, uterine perforation rate, infection rate and so on were observed in the two groups. Results: there was no uterine perforation in the two groups and three different abortion methods. Three kinds of different abortion methods showed that the rate of complete abortion was lower, the rate of incomplete abortion and abortion failure rate was higher, the excretion of pregnancy was slow, the amount of bleeding was more, the vaginal bleeding time was longer and the infection rate was higher in the scar uterus group than in the normal uterus group. But the difference was not statistically significant (P0.05). The rate of complete abortion was lower, the rate of incomplete abortion and abortion failure rate was higher, the excretion of pregnancy was slow, the amount of bleeding was more, the vaginal bleeding time was longer and the infection rate was high. The difference was statistically significant (P0.05). Drug flow combined with negative suction for the termination of early pregnancy scar uterine faster than negative aspiration pregnancy, less bleeding, vaginal bleeding time is short, the incidence of comprehensive abortion reaction and infection rate is low, the difference was statistically significant (P0.05). There was no significant difference in other observed indexes (P0.05). Conclusion: uterine scar reduces the rate of complete abortion, increases the failure rate of incomplete abortion and abortion, the amount and time of bleeding, and the incidence of infection after abortion. Drug flow combined with negative suction is a safe and effective method for the termination of early pregnancy with scar pregnancy, with less bleeding, shorter vaginal bleeding, less operation time, lower risk of uterine perforation and lower incidence of infection.
【学位授予单位】：宁波大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R169.42

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