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目的 评估人工流产术后即时口服雌二醇片/雌二醇地屈孕酮片(每片含雌二醇2 mg)对降低胚物残留(RPOC)二次手术、预防宫腔粘连(IUA)及促进子宫内膜修复的临床疗效。方法 回顾性分析行人工流产术的494例患者，其中对照组214例，为术后仅常规服用抗生素及益母草颗粒者，观察组280例，在常规治疗基础上立即加用雌二醇片/雌二醇地屈孕酮片(每片含雌二醇2 mg)。比较两组患者在人工流产术后RPOC二次手术率、IUA发生率、术后子宫内膜厚度恢复情况、术后阴道出血持续时间、月经复潮时间和复潮月经量及术后并发症情况的差异。结果 观察组RPOC二次手术率为0.4%，低于对照组的2.3%，但组间差异无统计学意义(P=0.13,Fisher精确检验)；观察组IUA发生率为1.8%，低于对照组的8.8%(P<0.05)；观察组术后2周子宫内膜厚度厚于对照组(P<0.05)；观察组术后阴道出血时间、月经复潮时间更短，术后盆腔感染、宫腔积液及月经量减少的发生率亦低于对照组，差异均有统计学意义(均P<0.05)。结论 人工流产术后立即口服雌二醇片/雌二醇地屈孕酮片可显著预防IUA、缩短术后阴道出血时间、促进内膜修复、改善月经恢复情况，并可能降低RPOC二次手术风险。
Abstract：Objective To evaluate the efficacy of immediate postoperative oral administration of 2 mg estradiol/estradiol dydrogesterone tablets in reducing secondary surgery for retainedproducts of conception(RPOC), preventing intrauterine adhesions(IUA), and promoting endometrial repair following induced abortion.Methods A retrospective analysis was conducted on 494 patients who underwent induced abortion. The control group(n=214) received conventional postoperative treatment with antibiotics and Yimucao granules, while the observation group(n=280) received immediate administration of estradiol/dydrogesterone tablets(each tablet contains 2 mg of estradiol),combined with antibiotics and Yimucao granules. The two groups were compared for the secondary surgery rate for RPOC, incidence of IUA, endometrial thickness at 2 weeks postoperatively, duration of postoperative vaginal bleeding, time to menstrual resumption, incidence of reduced menstrual volume after resumption, and postoperative complications(pelvic infection, intrauterine fluid accumulation). Results The observation group showed a lower rate of secondary surgery for RPOC compared to the control group(0. 4% vs 2. 3%), but the difference was not statistically significant(P=0. 13, Fisher's exact test). The observation group also had a significantly lower incidence of IUA(P<0. 05), greater postoperative endometrial thickness at 2 weeks(P<0. 05), and significantly shorter duration of postoperative vaginal bleeding and time to menstrual resumption. The incidence of reduced menstrual volume postoperatively and complications(pelvic infection, intrauterine fluid accumulation) were also significantly lower in the observation group(all P<0. 05). Conclusion Immediate oral administration of estradiol/dydrogesterone tablets after induced abortion significantly prevents intrauterine adhesions, shortens postoperative vaginal bleeding duration, promotes endometrial repair, improves menstrual recovery, and potentially reduces the risk of secondary surgery for retained products of conception.
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基本信息:
DOI：10.19405/j.cnki.issn1000-1492.2026.07.016
中图分类号:R169.42
引用信息:
[1]谢迎艳,张李松,黄晓武,等.人流后应用雌孕激素对胚物残留及宫腔粘连的疗效分析[J].安徽医科大学学报,2026,61(07):1277-1282.DOI:10.19405/j.cnki.issn1000-1492.2026.07.016.
基金信息:
北京市教育委员会科研计划项目(编号：KM202410025009)~~
2026-05-14
2026-05-14
2026-05-14