杨军欣+张传英+吴丽芬+曹亚琼+宋华+王鹤

【摘要】 目的 研究炔雌醇环丙孕酮片（达英35）对人工流产后子宫内膜及月经周期的保护作用。方法 150例自愿要求人工流产终止妊娠的早孕妇女， 随机分为实验组和对照组， 每组75例。两组患者均接受常规无痛人工流产手术及术后常规护理， 对照组术后服用抗生素及八珍益母丸， 实验组手术当天开始服用达英35。观察两组术后月經复潮时间和子宫内膜的恢复情况。结果 实验组术后月经复潮时间为（22.31±3.12）d、术后21 d子宫内膜厚度为（9.34±2.11）mm， 均优于对照组的（35.65±9.27）d、（4.17±2.32）mm， 差异有统计学意义（P<0.05）。实验组术后21 d月经复潮率为97.3%（73/75）， 明显高于对照组的73.3%（55/75）， 差异有统计学意义（P<0.05）。结论 达英35可有效促进人工流产术后子宫内膜的修复， 对子宫内膜及月经复潮具有保护作用， 值得临床推广。

【关键词】 炔雌醇环丙孕酮片；人工流产；子宫内膜；月经周期；保护作用

DOI：10.14163/j.cnki.11-5547/r.2017.17.055

Study on protective effect of Diane-35 for endometrium and menstrual cycle after artificial abortion YANG Jun-xin， ZHANG Chuan-ying， WU Li-fen， et al. Department of Gynaecology and Obstetrics， Jilin Province Fourth Peoples Hospital， Changchun 130012， China

【Abstract】 Objective To study the protective effect of ethinylestradiol and cyproterone acetate tablets （Diane-35） for endometrium and menstrual cycle after artificial abortion. Methods A total of 150 early pregnant women who voluntarily requiring induced abortion to terminate the pregnancy were randomly divided into experimental group and control group， with 75 cases in each group. Both groups received conventional painless induced abortion operation and postoperative routine nursing， and the control group received oral antibiotics and Bazhen Yimu pills after operation. The experimental group received oral Diane-35 from the day of surgery. Observation were made on postoperative return of menstruation time and endometrial recovery situation in two groups. Results The experimental group had postoperative return of menstruation time as （22.31±3.12） d and endometrial thickness in postoperative 21 d as （9.34±2.11） mm， which were all better than （35.65±9.27） d and （4.17±2.32） mm in the control group， and their difference had statistical significance （P<0.05）. The experimental group had obviously higher return of menstruation rate in postoperative 21 d as 97.3% （73/75） than 73.3% （55/75） in the control group， and the difference had statistical significance （P<0.05）. Conclusion Diane-35 can effectively accelerate endometrial repair after artificial abortion， and it has protective effect for endometrium and return of menstruation. So it is worthy of clinical promotion.

【Key words】 Ethinylestradiol and cyproterone acetate tablets； Artificial abortion； Endometrium； Menstrual cycle； Protective effect

我国每年约有1300万次人工流产发生， 重复流产率及短期内再次人工流产率不断上升， 这直接导致了人工流产手术及术后并发症发生率的增加[1]。人工流产术容易出现术后月经周期紊乱、子宫内膜损伤等一系列并发症[2]。本文着重探讨达英35在人工流产术后子宫内膜修复及月经周期恢复中的保护作用。现报告如下。

1 资料与方法

1. 1 一般资料 选择妇科门诊自2015年 1～6月自愿要求人工流产终止妊娠的早孕妇女150例。术前常规检查血尿常规、凝血常规、心电图、肝肾功能。妇科超声明确宫内妊娠。将其随机分为实验组与对照组， 各75例。两组患者既往月经规律、否认药物过敏史， 本次均为意外妊娠， 非口服避孕药失败或工具避孕失败。均自愿配合随期查访， 超聲检查结果均与停经时间符合。实验组年龄19～43 岁， 平均年龄 （28.5±5.3）岁， 孕次 1～3次， 平均孕次 （1.23±0.63）次， 产次0～2 次。……