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目的探讨负压吸引术中控制压力及时间对高危早期妊娠流产的近期临床疗效的影响。方法选取2013年10月-2014年10月在该院住院治疗的早期高危妊娠流产患者300例,随机分为研究组和对照组,每组150例,两组患者均行无痛负压吸引清宫术。研究组控制手术压力为100~350 mm Hg,宫腔操作时间≤75 s;对照组按照手术标准控制压力于150~450 mm Hg,不限制宫腔操作时间。比较手术时间、术中出血、术中负压大小、术后出血时间、月经复潮时间、月经量、术后第1个月及第3个月卵泡期子宫内膜厚度、术后闭经及宫颈粘连情况等。结果研究组的麻醉时间、宫腔操作时间和宫腔压力均明显低于对照组(均P<0.001);宫腔压力与孕囊大小呈正相关(P<0.05);宫腔内操作时间与年龄、孕周、孕囊大小和宫腔压力无明显相关性(均P>0.05);两组术后出血时间、月经复潮时间、闭经、宫颈粘连、宫内残留之间比较,差异无统计学意义(均P>0.05);术后第4个月随访,两组宫腔粘Ⅰ~Ⅳ级发生率比较,差异无统计学意义(P>0.05);术中压力和宫腔操作时间是影响术后第3个月卵泡期子宫内膜厚的因素(P<0.001)。结论对于高危早期妊娠实施人工流产负压吸引术中,控制压力及时间等措施可以明显减少宫腔粘连的发生率,减轻对子宫内膜的损伤,更好的保护患者子宫内膜。
Objective To investigate the effect of negative pressure aspiration control pressure and time on the recent clinical efficacy of high risk early pregnancy induced abortion. Methods From October 2013 to October 2014, 300 patients with early high-risk pregnancy induced abortion in our hospital were randomly divided into study group and control group, with 150 cases in each group. Painless and negative pressure was applied to both groups Surgery. In the study group, the control operation pressure was 100-350 mm Hg and the uterine cavity operation time was less than or equal to 75 s. The control group was operated under the control of 150-450 mm Hg according to the operation standard without limitation of uterine cavity operation time. Comparison of operative time, intraoperative bleeding, intraoperative negative pressure, postoperative bleeding time, menstrual cramps, menstrual flow, 1 month after surgery and 3 months of follicular endometrial thickness, postoperative amenorrhea and cervix Adhesions and so on. Results The anesthesia time, intrauterine operation time and intrauterine pressure in the study group were significantly lower than those in the control group (all P <0.001); the intrauterine pressure was positively correlated with the size of the gestational sac (P <0.05); intrauterine operation time and age , Gestational age, gestational sac size and intrauterine pressure had no significant correlation (all P> 0.05); two groups of postoperative bleeding time, menstrual recuperation time, amenorrhea, cervical adhesions, intrauterine residue, the difference was not statistically significant (All P> 0.05). There was no significant difference in the incidence of grade Ⅰ ~ Ⅳ of visceral adhesions between the two groups at the 4th month after operation (P> 0.05). The intraoperative pressure and intrauterine operation time Factors of endometrial thickness in follicular phase at the third month after operation (P <0.001). Conclusions For the treatment of abortion induced abortion in high-risk early pregnancy, the measures such as controlling pressure and time can significantly reduce the incidence of intrauterine adhesions, reduce the damage to the endometrium and better protect the endometrium of patients.