摘要
目的 比较不同种类和剂量的雌孕激素减少药物流产后阴道出血的临床疗效.方法 将对象随机分为复方短效口服避孕药组（COC组）于胚囊排出当日起口服去氧孕烯炔雌醇片1片/d,连服21 d；雌孕激素序贯治疗组（E＋P组）,于胚囊排出当日起口服戊酸雌二醇片2 mg/d,连服21 d,最后5d同时加服醋酸甲羟孕酮片10 mg/d；对照组不服用雌孕激素类药物.比较3组药物流产后阴道出血、月经恢复以及药物流产结局.结果E＋P组与对照组相比药物流产后出血天数明显缩短,分别为（14±7）d和（19±11）d,P＜0.01,而COC组为（20±13）d,与对照组相比差异无统计学意义（P＞0.05）.3组阴道出血量的差异无统计学意义（x2=1.274,P＞0.05）.转经天数E＋P组为（30 ±7）d、COC组为（34 ±13）d,分别与对照组（39 ±11）d相比差异有统计学意义（P＜0.05）,但E＋P组与COC组间的差异无统计学意义（P＞0.05）.3组间不全流产发生率的差异无统计学意义（X2 =1.465,P＞0.05）.结论 药物流产后应用雌孕激素序贯治疗能有效减少药物流产后阴道出血时间,而复方短效口服避孕药对减少阴道出血的疗效不明显,但二者均能有效促进药物流产后恢复,且疗效相似.
Objective To compare the different effects of taking different kinds and doses of estrogen and progestogen after medical abortion on reducing vaginal hemorrhage time.Methods A total of 188 women undergoing medical abortion were recruited and randomized into 3 groups：group A（n =41）starting marvelon（30 μg ethinylestradiol and 150 μg desogestrel）on the day of abortion for 21 days; group B（n =53）starting progynova 2 mg/d on the day of abortion for 21 days and taking depogeston 10 mg/d on the last 5 days; and group C（n =94）as controL The vaginal hemorrhage time,days to onset of next menses and the outcome of medical abortion were compared.Results There was no significant difference in the duration of hemorrhage between groups A and C[（20 ± 13）vs（19 ± 11）d,P 〉 0.05].But the duration of hemorrhage in group B was significantly shorter than that in group C[（14 ±7）vs（19：±11）d,P〈0.01].There was no significant difference in the amount of hemorrhage among 3 groups（P 〉 0.05）.The time to onset of first menses was similar between groups A and B[（34 ± 13）vs（30 ±7）d].And both were significantly shorter than that in group C[（39 ± 11）d,P 〈 0.05].There were 3（7.32%）incomplete abortions in group A,4（7.55%）in group B and 12（12.77%）in group C（P 〉 0.05）.Conclusion The sequential therapy of estrogen and progestogen after medical abortion may effectively reduce the duration of hemorrhage.And the combined oral contraceptive pills fail to significantly alter the duration of hemorrhage after medical abortion.But both can promote menstrual recovery significantly.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2011年第45期3179-3181,共3页
National Medical Journal of China
关键词
药物流产
去氧孕烯
复方口服避孕药
戊酸雌二醇
Abortion,drug-induced
Desogestrel
Oral contraceptives, combined
Estradiol
