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目的分析黄体酮阴道凝胶联合地屈孕酮治疗不明原因早期复发性流产(URSA)的有效性。方法选取2012年6月-2014年6月该院生殖中心收治的不明原因早期复发性流产(URSA)患者146例为研究对象,随机分为研究组和对照组,每组各73例。两组患者进行监测排卵指导同房。确认妊娠后研究组采用黄体酮阴道缓释凝胶联合地屈孕酮黄体支持直至妊娠90d,对照组采用黄体酮针剂肌肉注射联合地屈孕酮治疗。比较两组患者的妊娠率、先兆流产症状发生率、难免流产率及继续妊娠率。结果两组患者监测排卵指导同房后妊娠率及妊娠后血清hCG及孕酮水平差异无统计学意义(P>0.05)。两组阴道流产等先兆流产症状发生率差异无统计学意义(P>0.05);研究组难免流产率(22.2%)显著低于对照组(42.9%),差异有统计学意义(P<0.05)。继续妊娠率显著高于对照组,差异有统计学意义(P<0.05)。结论对有URSA史的患者给黄体酮阴道凝胶联合地屈孕酮片治疗能够有效降低再次妊娠难免流产的概率。
Objective To analyze the effectiveness of progesterone vaginal gel combined with dydrogesterone in the treatment of unexplained early recurrent spontaneous abortion (URSA). Methods A total of 146 patients with unexplained early recurrent spontaneous abortion (URSA) admitted to the Reproductive Center of our hospital from June 2012 to June 2014 were selected as study subjects and randomly divided into study group and control group with 73 cases in each group. Two groups of patients to monitor ovulation guidance of the same room. Confirmed that after pregnancy, the study group using progesterone vaginal sustained release gel combined with progesterone luteal support until pregnancy 90d, the control group using progesterone injection intramuscular injection combined with dydrogesterone treatment. The pregnancy rate, the incidence of threatened abortion symptoms, the inevitable abortion rate and the continuous pregnancy rate were compared between the two groups. Results There was no significant difference in serum hCG and progesterone levels between the two groups in monitoring ovulation-guided pregnancy rate and pregnancy after pregnancy (P> 0.05). There was no significant difference in the incidence of threatened abortion among the two groups (P> 0.05). The inevitable abortion rate (22.2%) in the study group was significantly lower than that in the control group (42.9%) (P <0.05) . The pregnancy rate was significantly higher than the control group, the difference was statistically significant (P <0.05). Conclusion The treatment of progesterone vaginal gel combined with dydrogesterone tablets in patients with a history of URSA can effectively reduce the probability of refractory abortion.