朱丹阳++++++赵秀敏++++++陈晓璐

[摘要] 目的 观察流产后即时口服避孕药是否有助于降低术后再次清宫率。方法 患者随机分为观察组（术后口服优思明）与对照组各100例，人流术后7天复查B超，正常者每个月随访1次，异常者每周随访1次至正常后转为每个月1次。 结果 观察组B超正常者85例、异常者15例，阴道出血、转经时间分别为（4±0.6）、（28±3.4）、（8.3±1.9）、（31±3.5）d，再次刮宫者0例。对照组正常者82例，异常者18例，阴道出血、转经时间分别为（7±1.5）、（35±2.3）、（12.3±2.1）、（35±4.5）d，再次刮宫者6例。两组阴道出血、转经时间、再次刮宫率存在显著差异（P<0.05）。 结论人流术后口服避孕药缩短阴道出血及转经时间，降低再次清宫率。

[关键词] 人工流产；人流不全；口服避孕药

[中图分类号] R169.4[文献标识码] B[文章编号] 1673-9701（2014）16-0143-03

A clinical observation of the effects of taking oral contraceptives timely after abortion on reducing the rate of postoperative uterus cleaning

ZHU Danyang ZHAO Xiumin CHEN Xiaolu

Department of Gynecology, the First Peoples Hospital of Taizhou City in Zhejiang Province,Taizhou 318020，China

[Abstract] Objective To observe whether taking oral contraceptives timely after abortion helps reduce the rate of repeated uterus cleaning. Methods Patients were randomly assigned to observation group(orally taking Yasmin after abortion) and control group, with 100 patients in each group. They were received type-B ultrasound seven days after abortion. The patients with normal test results were visited once a month and the patients with abnormal test results were visited once a week, and once a month after the results became normal. Results Eighty-five patients in observation group had normal test results and 15 had abnormal results. Durations of vaginal bleeding and resuming to normal menstruation were（4±0.6）, （28±3.4）, （8.3±1.9）, and （31±3.5） days respectively. No patients were received dilation and curettage again. 82 patients in control group had normal test results and 18 had abnormal results. The durations of vaginal bleeding and resuming to normal menstruation were (7±1.5), (35±2.3), (12.3±2.1), and (35±4.5) days respectively. Six patients were received dilation and curettage again. The differences of the durations of vaginal bleeding, resuming to normal menstruation and the rate of repeated uterus cleaning between the two groups were statistically significant(P<0.05). Conclusion Taking oral contraceptives after abortion helps shorten the durations of vaginal bleeding and resuming to normal menstruation, and reduce the rate of repeated uterus cleaning.

[Key words] Abortion; Incomplete abortion; Oral contraceptives流产后即时口服避孕药早已列入世界卫生组织生殖健康与研究部编著的《避孕方法选用的医学标准》中。同时研究[1，2]亦发现人流术后口服避孕药的诸多非避孕益处，包括减少术后出血量、维持正常月经周期、预防盆腔感染、防止宫腔粘连等。有报道应用安宫黄体酮[3]治疗人流不全取得较好效果，作为同样含有孕激素制剂的口服避孕药能否起到同样效果目前未见报道，本研究观察100例人流术后应用口服避孕药的患者，现报道如下。

1资料与方法

1.1 一般资料

选取自2010年9月1日～2011年8月31日来我院妇科门诊要求人工流产终止非意愿妊娠妇女200例，根据随机数字表法分为观察组（n=100）与对照组（n=100）（分组征得患者本人知情同意）。术前排除基础疾病或避孕药使用禁忌。

1.2 方法

两组患者在我科门诊手术室由专人行人工流产术（负压吸引术），术后均予抗生素、益母草合剂预防感染，促子宫收缩治疗5 d。……