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目的:探讨药物流产后子宫异常出血手术(清宫)的时机。方法:以我院近2年要求药物流产且资料完整的318例妇女的病历资料为研究对象,回顾性分析药物流产服药前、后静脉血β-hCG、孕酮(P)水平;同时分析比较药流后完全流产组(n=240)和不全流产组(n=78)血清β-hCG、P值下降程度、超声与清宫的关系。结果:血β-hCG于药物流产前、后第8日下降幅度在完全流产组和不全流产组间比较无统计学差异(P>0.05),完全流产组下降百分比(95.98%)明显高于不全流产组(86.87%),组间比较有显示性差异(P<0.05);而P下降幅度组间比较无统计学差异(P>0.05),但不全流产组血P值第8日高于对照组,且处于较高水平。不全流产组超声显示宫内有中强回声或强光带。结论:药流后第8日血β-hCG下降百分比≤90%,P值处于较高水平,可能是预测不全流产需要清宫的指标。再结合超声显示宫内中强回声或强光带者应尽早行清宫术,以解除流产后子宫异常出血的根本原因,从而降低药物流产的并发症。
Objective: To explore the timing of abnormal uterine bleeding after medical abortion (Qing palace). Methods: The data of medical records of 318 women who requested medical abortion and complete data in our hospital for the past two years were used as research objects. The levels of β-hCG and progesterone (P) in blood before and after medical abortion were analyzed retrospectively. Serum levels of β-hCG in the abortion group (n = 240) and incomplete abortion group (n = 78) after drug abortion, the decrease of P value, the relationship between ultrasound and Qing palace. Results: The blood β-hCG decreased on the 8th day after the drug abortion had no significant difference between the complete abortion group and the incomplete abortion group (P> 0.05). The percentage of complete abortion group (95.98%) was significantly higher than that of the incomplete abortion group Abortion group (86.87%) showed significant difference between the two groups (P <0.05), while the P decrease range was no significant difference (P> 0.05), but the incomplete blood loss group blood P value was higher than the control Group, and at a high level. Incomplete abortion group showed intrauterine ultrasound echo or glare band. Conclusion: The percentage of decline of β-hCG on the 8th day after drug abortion is less than or equal to 90%, and the P value is at a high level, which may be an indicator of the need of Qing Dynasty in predicting incomplete abortion. Combined with ultrasound showed intrauterine echogenic or glaucoma who should curettage as soon as possible in order to lift the root cause of abnormal uterine bleeding after abortion so as to reduce the complications of medical abortion.