屈螺酮炔雌醇片对人工流产孕妇子宫血流动力学、内膜微血管密度的影响及意义
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摘要
目的观察屈螺酮炔雌醇片对人工流产孕妇子宫血流动力学、内膜微血管密度的影响。方法采用随机数字表法将我院2016年1月—2017年10月期间收治的140例人工流产患者分为2组。所有研究对象人工流产术后均给予甲硝唑、新生化颗粒等基础治疗。给予屈螺酮炔雌醇片口服治疗者为屈螺酮炔雌醇片组,对照组给予安慰剂。比较两组患者人工流产术后恢复情况以及治疗前后子宫血流动力学、内膜微血管密度变化。结果观察组患者阴道流血时间、月经恢复时间短于对照组,阴道流血量少于对照组,差异均具有统计学意义(P<0.05)。治疗前两组患者子宫动脉搏动指数(PI)、阻力指数(RI)、血流量(PBF)及血流峰值速度(V_(max))比较,差异无统计学意义(P>0.05),治疗后屈螺酮炔雌醇片组PI、PBF、V_(max)高于对照组,RI低于对照组,差异具有统计学意义(P<0.05)。治疗前,两组患者后子宫内膜微血管密度(MVD)、血红蛋白(Hb)含量、凝血酶原时间(PT)和部分凝血酶时间(APTT)比较差异无统计学意义(P>0.05);治疗后屈螺酮炔雌醇片组MVD、Hb、APTT高于对照组,PT低于对照组,差异具有统计学意义(P<0.05)。结论屈螺酮炔雌醇通过影响人工流产手术患者子宫血流动力学及子宫内膜微血管密度,能够快速止血,促进患者康复。
Objective To observe the influence of drospirenone and Ethinylestradiol Tablets for uterine hemodynamics and microvascular density of endometrium in women after induced abortion. Methods 140 cases of women after induced abortion in our hospital from January,2016 to October, 2017 were divided into two groups by the random digital table method.All subjects were given the basic treatment of metronidazole and new biochemical granules after artificial abortion.The observation group were given oral administration of Drospirenone and Ethinylestradiol Tablets,while the control group was given oral placebo.Then,the recovery of induced abortion and the changes of uterine hemodynamics and intima microvessel density before and after treatment of two groups of patients were compared. Results The time of vaginal bleeding and the recovery time of menstruation in the observation group were shorter than that in the control group,and the volume of vaginal bleeding was less than that in the control group, and the difference was statistically significant(P<0.05).Before the treatment, there was no significant difference in uterine artery pulsatility index(PI), resistance index(RI), blood flow volume(PBF) and blood flow peak velocity(Vmax) between the two groups(P>0.05).After the treatment, the PI, PBF and Vmax in the observation group were higher than those in the control group, and the RI was lower than that in the control group,and the difference was statistically significant(P<0.05).Before the treatment, there was no significant difference in endometrial microvessel density(MVD), hemoglobin(Hb) content, prothrombin time(PT) and partial thromboplastin time(APTT) between the two groups(P>0.05).After the treatment, the MVD, Hb and APTT in the observation group were higher than those in the control group, and the PT was lower than the control group,and the difference was statistically significant(P<0.05). Conclusion The uterine hemodynamics and the microvascular density of the endometrium in patients with induced abortion are affected by the effect of wstugone estriol,which can quickly stop bleeding and promote the recovery of the patients.
Objective To observe the influence of drospirenone and Ethinylestradiol Tablets for uterine hemodynamics and microvascular density of endometrium in women after induced abortion. Methods 140 cases of women after induced abortion in our hospital from January,2016 to October, 2017 were divided into two groups by the random digital table method.All subjects were given the basic treatment of metronidazole and new biochemical granules after artificial abortion.The observation group were given oral administration of Drospirenone and Ethinylestradiol Tablets,while the control group was given oral placebo.Then,the recovery of induced abortion and the changes of uterine hemodynamics and intima microvessel density before and after treatment of two groups of patients were compared. Results The time of vaginal bleeding and the recovery time of menstruation in the observation group were shorter than that in the control group,and the volume of vaginal bleeding was less than that in the control group, and the difference was statistically significant(P<0.05).Before the treatment, there was no significant difference in uterine artery pulsatility index(PI), resistance index(RI), blood flow volume(PBF) and blood flow peak velocity(Vmax) between the two groups(P>0.05).After the treatment, the PI, PBF and Vmax in the observation group were higher than those in the control group, and the RI was lower than that in the control group,and the difference was statistically significant(P<0.05).Before the treatment, there was no significant difference in endometrial microvessel density(MVD), hemoglobin(Hb) content, prothrombin time(PT) and partial thromboplastin time(APTT) between the two groups(P>0.05).After the treatment, the MVD, Hb and APTT in the observation group were higher than those in the control group, and the PT was lower than the control group,and the difference was statistically significant(P<0.05). Conclusion The uterine hemodynamics and the microvascular density of the endometrium in patients with induced abortion are affected by the effect of wstugone estriol,which can quickly stop bleeding and promote the recovery of the patients.
引文
1 祝鑫瑜,赵海燕,王莉,等.不同负压对不全流产以及子宫内膜损伤的影响.华中科技大学学报(医学版),2014,43:106-108.
2 冯贤英,李馨.人工流产术后产生并发症的相关因素分析及预防措施.浙江创伤外科,2016,21:410-412.
3 栾晓蕊,董倩.人工流产术后即时应用口服避孕药屈螺酮炔雌醇片(Ⅱ)的临床观察.中国计划生育学杂志,2017,25:570-571.
4 刘福先.妇科千金胶囊联合屈螺酮炔雌醇片对人工流产术后阴道出血及子宫内膜修复的影响.现代中西医结合杂志,2017,26:2543-2545.
5 Momoeda M,Kondo M,Elliesen J,et al.Efficacy and safety of a flexible extended regimen of ethinylestradiol/drospirenone for the treatment of dysmenorrhea:a multicenter,randomized,open-label,active-controlled study.Int J Womens Health.2017,9:295-305.
6 俞艳锦,黄丽丽.人工流产现状及对策.中国计划生育学杂志,2013,21:710 -712.
7 韩婷婷,刘恋,凌丹丹,等.湖南长沙地区育龄期女性生殖健康状况的调查.生殖医学杂志,2015,24:46-50.
8 万颖.月经紊乱与子宫内膜血流情况及甲状腺激素水平的相关性分析.中国妇幼保健,2017,32:2073-2076.
9 张玲玲,郭瑞君.子宫血流超声参数在评估体外受精-胚胎移植患者子宫内膜容受性中的应用.临床超声医学杂志,2017,19:404-407.
10 蒋文胜.不同子宫内膜厚度采用不同激素药物治疗围绝经期功血的疗效分析.深圳中西医结合杂志,2017,27:116-117.
11 王哲蔚,洪向丽,朱盈.原因不明月经过少妇女的临床特征和受孕结局.生殖与避孕,2015,35:730-734.
12 孙利娟,尹利荣.B超监视下人工流产术后口服屈螺酮炔雌醇片的临床观察.齐齐哈尔医学院学报,2017,38:1424-1426.
13 谭舒尹,蒙达华,吕华超,等.子宫内膜容积及血管化参数与复发性流产的相关性研究.中国妇幼保健,2015,30:5006-5009.
14 王宝菊,黄明莉,刘骥,等.血管生长异常与流产的关系研究进展.现代生物医学进展,2015,15:960-962.
15 葛红领.妇科千金胶囊联合去氧孕烯炔雌醇片对人工流产手术后患者康复的影响.新中医,2014,46:126-128.
16 Marr J,Huang Z,Wang B,et al.Efficacy and safety of an oral contraceptive containing ethinylestradiol 20 μg/drospirenone 3 mg (24/4 regimen) in three indications in the People′s Republic of China:a comparison with international studies.Contracept.2015,6:95-104.
17 Madendag Y,Acmaz G,Atas M,et al.The Effect of Oral Contraceptive Pills on the Macula,the Retinal Nerve Fiber Layer,and Choroidal Thickness.Med Sci Monit.2017,27:5657-5661.
18 Amiri M,Nahidi F,Khalili D,et al.TComparing the Effects of Oral Contraceptives Containing Levonorgestrel With Products Containing Antiandrogenic Progestins on Clinical,Hormonal,and Metabolic Parameters and Quality of Life in Women With Polycystic Ovary Syndrome:Crossover Randomized Controlled Trial Protocol.J MIR Res Protoc,2017,29,6:e191.
19 Harada T,Kosaka S,Elliesen J.Ethinylestradiol 20 μg/drospirenone 3 mg in a flexible extended regimen for the management of endometriosis-associated pelvic pain:a randomized controlled trial.Fertil Steril.2017,108:798-805.
2 冯贤英,李馨.人工流产术后产生并发症的相关因素分析及预防措施.浙江创伤外科,2016,21:410-412.
3 栾晓蕊,董倩.人工流产术后即时应用口服避孕药屈螺酮炔雌醇片(Ⅱ)的临床观察.中国计划生育学杂志,2017,25:570-571.
4 刘福先.妇科千金胶囊联合屈螺酮炔雌醇片对人工流产术后阴道出血及子宫内膜修复的影响.现代中西医结合杂志,2017,26:2543-2545.
5 Momoeda M,Kondo M,Elliesen J,et al.Efficacy and safety of a flexible extended regimen of ethinylestradiol/drospirenone for the treatment of dysmenorrhea:a multicenter,randomized,open-label,active-controlled study.Int J Womens Health.2017,9:295-305.
6 俞艳锦,黄丽丽.人工流产现状及对策.中国计划生育学杂志,2013,21:710 -712.
7 韩婷婷,刘恋,凌丹丹,等.湖南长沙地区育龄期女性生殖健康状况的调查.生殖医学杂志,2015,24:46-50.
8 万颖.月经紊乱与子宫内膜血流情况及甲状腺激素水平的相关性分析.中国妇幼保健,2017,32:2073-2076.
9 张玲玲,郭瑞君.子宫血流超声参数在评估体外受精-胚胎移植患者子宫内膜容受性中的应用.临床超声医学杂志,2017,19:404-407.
10 蒋文胜.不同子宫内膜厚度采用不同激素药物治疗围绝经期功血的疗效分析.深圳中西医结合杂志,2017,27:116-117.
11 王哲蔚,洪向丽,朱盈.原因不明月经过少妇女的临床特征和受孕结局.生殖与避孕,2015,35:730-734.
12 孙利娟,尹利荣.B超监视下人工流产术后口服屈螺酮炔雌醇片的临床观察.齐齐哈尔医学院学报,2017,38:1424-1426.
13 谭舒尹,蒙达华,吕华超,等.子宫内膜容积及血管化参数与复发性流产的相关性研究.中国妇幼保健,2015,30:5006-5009.
14 王宝菊,黄明莉,刘骥,等.血管生长异常与流产的关系研究进展.现代生物医学进展,2015,15:960-962.
15 葛红领.妇科千金胶囊联合去氧孕烯炔雌醇片对人工流产手术后患者康复的影响.新中医,2014,46:126-128.
16 Marr J,Huang Z,Wang B,et al.Efficacy and safety of an oral contraceptive containing ethinylestradiol 20 μg/drospirenone 3 mg (24/4 regimen) in three indications in the People′s Republic of China:a comparison with international studies.Contracept.2015,6:95-104.
17 Madendag Y,Acmaz G,Atas M,et al.The Effect of Oral Contraceptive Pills on the Macula,the Retinal Nerve Fiber Layer,and Choroidal Thickness.Med Sci Monit.2017,27:5657-5661.
18 Amiri M,Nahidi F,Khalili D,et al.TComparing the Effects of Oral Contraceptives Containing Levonorgestrel With Products Containing Antiandrogenic Progestins on Clinical,Hormonal,and Metabolic Parameters and Quality of Life in Women With Polycystic Ovary Syndrome:Crossover Randomized Controlled Trial Protocol.J MIR Res Protoc,2017,29,6:e191.
19 Harada T,Kosaka S,Elliesen J.Ethinylestradiol 20 μg/drospirenone 3 mg in a flexible extended regimen for the management of endometriosis-associated pelvic pain:a randomized controlled trial.Fertil Steril.2017,108:798-805.