瘢痕子宫患者采用药物终止早期妊娠的治疗效果观察

摘要

目的 探讨合并瘢痕子宫患者采用药物流产终止早期妊娠的治疗效果.方法 收集2014年1月～ 2015年12月新疆医科大学第二附属医院妇科合并瘢痕子宫患者早期妊娠采用药物流产的病例215例作为病例组,未合并瘢痕子宫者574例作为对照组,均给予相同剂量的米非司酮及米索前列醇进行药物流产,观察两组完全流产、不全流产、流产失败的概率,孕囊排出时间,阴道流血量及不良反应.结果 病例组药物流产成功率为87.4％,对照组的药物流产成功率为89.1％,二者差异无统计学意义;病例组在服用米索前列醇后孕囊排出时间平均为4.24h,对照组为2.57h,二者比较差异有统计学意义(P＜0.05);两组患者出血量均集中在50 ～ 80ml,其中病例组中阴道出血量＞80ml占21.4％,对照组为13.3％,且二者比较差异有统计学意义(P＜0.05);两组均未发生严重的不良反应,主要为恶心、呕吐、腹泻等胃肠道反应,差异无统计学意义(P＞0.05).结论 合并瘢痕子宫患者采用药物流产术终止早期妊娠是可行的,但需密切观察患者服药后孕囊排出时间、阴道出血量及药物的不良反应.%Objective To investigate the therapeutic effect of termination of early pregnancy by drug abortion in patients with scar uterus.Method Collected in January 2014-2015 in the Second Affiliated Hospital of Xinjiang Medical University in cases of gynecological patients with scar uterus in early pregnancy with drug abortion in the case of 215 cases as a case group,574 cases of patients without scar uterus as control group,all patients were given the same dose of mifepristone and misoprostol for medical abortion.Observe two groups of complete abortion,incomplete abortion,abortion failure probability,gestational sac discharge time,vaginal bleeding volume and adverse reactions.Results The success rate of drug abortion in case group was 87.4％,the success rate of drug abortion was 89.1％ in the control group,there was no significant difference between the two groups;In the case group,the average time of gestational sac was 4.24h,the control group was 2.57h,there was significant statistical difference between the two groups;Two groups of patients with blood loss were concentrated in 50-80ml,vaginal bleeding more than 80ml accounted for 21.4％ in the case group,the control group was 13.3％,and there were significant statistical differences between the two groups;There were no serious adverse reactions in the two groups,the main adverse reactions were nausea,vomiting,diarrhea and other gastrointestinal reactions,no significant statistical difference.Conclusion Patients with uterine scar by drug abortion for early pregnancy termination is feasible,however,it is necessary to observe the time of delivery,the amount of vaginal bleeding and the adverse drug reactions.