【摘要】：目的:探討子宮瘢痕對早孕流產的影響,為瘢痕子宮早孕尋求安全有效流產方法。方法:選取2015年6月~2016年10月寧波大學附屬陽明醫(yī)院計劃生育門診和病房藥物流產(以下簡稱藥流)或負壓吸引術(以下簡稱負吸術)或藥流聯(lián)合負吸術三種方法終止早孕的588例婦女為研究對象,其中瘢痕子宮早孕291例,藥流、負吸術及藥流聯(lián)合負吸術各97例;正常子宮早孕297例,藥流、負吸術及藥流聯(lián)合負吸術各99例。觀察兩組三種不同流產方法的完全流產率、不全流產率、流產失敗率、妊娠物排出時間、出血量、陰道流血時間、人流綜合反應發(fā)生率、子宮穿孔率、感染率等情況。結果:兩組三種不同流產方法均無子宮穿孔發(fā)生;藥流無人流綜合反應發(fā)生。三種不同流產方法顯示瘢痕子宮組較正常子宮組完全流產率低,不全流產率和流產失敗率高,妊娠物排出慢,出血量多,陰道流血時間長,感染率高,但差異均無統(tǒng)計學意義(P0.05)。藥流終止瘢痕子宮早孕較負吸術或藥流聯(lián)合負吸術完全流產率低,不全流產率和流產失敗率高,妊娠物排出慢,出血量多,陰道流血時間長,感染率高,差異均有統(tǒng)計學意義(P0.05);藥流聯(lián)合負吸術終止瘢痕子宮早孕較負吸術妊娠物排出快,出血量少,陰道流血時間短,人流綜合反應發(fā)生率及感染率低,差異均有統(tǒng)計學意義(P0.05),其余觀察指標差異無統(tǒng)計學意義(P0.05)。結論:子宮瘢痕降低完全流產率,增加不全流產和流產失敗率、出血量和流血時間及流產后感染發(fā)生率。藥流聯(lián)合負吸術終止瘢痕子宮早孕流產效果可靠,出血量少,陰道流血時間短,減少手術操作時間,降低子宮穿孔風險及感染發(fā)生率,是終止瘢痕子宮早孕安全有效的方法。
[Abstract]:Objective: to explore the effect of uterine scar on early pregnancy and to find a safe and effective method for early pregnancy. Methods: from June 2015 to October 2016, three prescriptions of drug abortion (hereinafter referred to as drug abortion) or negative pressure suction (hereinafter referred to as negative suction) or combination of drug flow and negative suction were selected in the family planning clinic and ward of Yangming Hospital affiliated to Ningbo University. 588 women who had terminated their early pregnancy were studied. There were 291 cases of early pregnancy with scar uterus, 97 cases of drug flow, 97 cases of negative suction and 97 cases of combined negative aspiration. There were 297 cases of normal early pregnancy, 99 cases of drug flow, 99 cases of negative suction and 99 cases of combined negative aspiration. The complete abortion rate, incomplete abortion rate, abortion failure rate, pregnancy excretion time, bleeding volume, vaginal bleeding time, rate of synthetic reaction of abortion, uterine perforation rate, infection rate and so on were observed in the two groups. Results: there was no uterine perforation in the two groups and three different abortion methods. Three kinds of different abortion methods showed that the rate of complete abortion was lower, the rate of incomplete abortion and abortion failure rate was higher, the excretion of pregnancy was slow, the amount of bleeding was more, the vaginal bleeding time was longer and the infection rate was higher in the scar uterus group than in the normal uterus group. But the difference was not statistically significant (P0.05). The rate of complete abortion was lower, the rate of incomplete abortion and abortion failure rate was higher, the excretion of pregnancy was slow, the amount of bleeding was more, the vaginal bleeding time was longer and the infection rate was high. The difference was statistically significant (P0.05). Drug flow combined with negative suction for the termination of early pregnancy scar uterine faster than negative aspiration pregnancy, less bleeding, vaginal bleeding time is short, the incidence of comprehensive abortion reaction and infection rate is low, the difference was statistically significant (P0.05). There was no significant difference in other observed indexes (P0.05). Conclusion: uterine scar reduces the rate of complete abortion, increases the failure rate of incomplete abortion and abortion, the amount and time of bleeding, and the incidence of infection after abortion. Drug flow combined with negative suction is a safe and effective method for the termination of early pregnancy with scar pregnancy, with less bleeding, shorter vaginal bleeding, less operation time, lower risk of uterine perforation and lower incidence of infection.
【學位授予單位】：寧波大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R169.42

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