人流不全的临床特点分析及生育情况调查

发布时间：2018-04-27 13:42

本文选题：人流不全 + 并发症　；参考：《中国工程科学》2015年06期

【摘要】：目的:分析人流不全的临床特点,探讨其发生的高危因素,同时调查患者术后的生育及避孕情况。方法:对首都医科大学附属北京妇产医院2007年10月—2012年10月收治的55例人流不全病历进行回顾性病例分析以及电话随访了解其生育情况及避孕情况。结果:人流不全的主要临床表现为人流术后的异常阴道出血42例(42/55,76.4%)以及月经异常13例(13/55,23.6%),超声检查可以发现人流不全造成的宫腔内异常,但需要结合人绒毛膜促性腺激素(HCG)水平的测定以及术后的病理来诊断人流不全。B超下的清宫手术能有效地清除残留的妊娠组织,术后均未再发现宫腔残留。人流不全的高危因素中主要的客观因素为子宫过度屈曲,占23.6%(13/55),主要的主观因素为宫颈扩张不够,占25.5%(14/55)。二次清宫术后主要并发症为宫腔粘连,发生率为5.5%(3/55)。55例患者术后共随访到29例患者,有17例再次妊娠,其中11例妊娠分娩,6例选择人工流产终止妊娠,未发现人流不全二次清宫对生育的明显不良影响。无生育要求的妇女均有意识采取避孕方法来避免意外妊娠。结论:人流不全的主要临床表现为手术后异常的阴道出血,通过结合尿或血的HCG检查以及B超检查,可以及时地发现人流不全。超声指导下清宫是治疗的有效办法。人流不全发生的高危因素,主要客观因素为子宫过度屈曲,主要主观因素为宫颈扩张不够。对于存在高危因素的手术采取超声指示下手术,能够有效地降低人流不全的发生率。人流不全二次清宫术后主要手术并发症为宫腔粘连,无手术并发症发生的患者,未发现明显生育能力的受损。但是对于避孕方法的选择,还需要更多的计划生育服务来帮助她们采取高效的避孕方法。
[Abstract]:Objective: to analyze the clinical characteristics of abortion insufficiency, to explore the high risk factors of its occurrence, and to investigate the fertility and contraception after operation. Methods: a retrospective analysis of 55 cases of abortion from October 2007 to October 2012 in Beijing Obstetral Hospital affiliated to Capital Medical University was carried out, as well as telephone follow-up to find out the fertility and contraception status. Results: the main clinical manifestations of abortion insufficiency were 42 cases of abnormal vaginal bleeding after abortion (42 cases) and 13 cases of abnormal menstruation (13 / 5 5% 23.6%). However, the detection of HCG in human chorionic gonadotropin (HCG) and postoperative pathology should be combined to diagnose the abortion insufficiency. Uterine residual tissue can be removed effectively by uterine clearing operation under B-ultrasound, and no residual intrauterine cavity is found after operation. The main objective factor in the high risk factors of abortion insufficiency was uterine overflexion, accounting for 23.6% / 55%, and the main subjective factor was that cervical dilatation was not enough, accounting for 25.5% of 55%. The main complication after secondary uterine clearance was intrauterine adhesions, the incidence of which was 5. 5 / 55. 55 patients were followed up to 29 patients, 17 of them were pregnant again, among which 11 cases were pregnant and 6 cases chose artificial abortion to terminate pregnancy. No obvious adverse effects of the second Qing Palace on fertility were found. Women who are not required to have children are conscious of using contraception to avoid unwanted pregnancies. Conclusion: the main clinical manifestation of abortion insufficiency is abnormal vaginal bleeding after operation. By combining urine or blood HCG examination and B-ultrasound examination, we can find the abortion insufficiency in time. It is an effective method to clear the uterus under the guidance of ultrasound. The main objective factors were uterine overflexion and the main subjective factors were cervical dilatation. Ultrasound-guided surgery for high-risk factors can effectively reduce the incidence of abortion insufficiency. The main complication after secondary uterine clearance was intrauterine adhesions, but no significant impairment of fertility was found in the patients with no complications. But more family planning services are needed to help them choose contraceptive methods.
【作者单位】：首都医科大学附属北京妇产医院计划生育科;
【分类号】：R169.42

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