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目的观察宫腔镜联合去氧孕烯炔雌醇治疗药物流产不全术后继发不孕的防治效果。方法选择2011年5月-2015年5月药物流产不全行清宫术且有生育要求的患者800例作为研究对象,将其随机分为试验组和对照组各400例,试验组行宫腔镜下清宫术,术后给予去氧孕烯炔雌醇口服治疗;对照组行常规清宫术。比较2组患者继发不孕的发生率及继发不孕的原因。结果试验组继发不孕率为10.0%(40/400)低于对照组的15.0%(60/400),差异有统计学意义(P<0.05)。2组排卵障碍、子宫内膜异位症引起的不孕率比较差异均无统计学意义(P>0.05);试验组输卵管因素、盆腔炎性疾病及子宫内膜因素引起的不孕率均低于对照组,差异均有统计学意义(P<0.05)。结论宫腔镜联合去氧孕烯炔雌醇治疗药物流产不全可有效预防术后继发不孕的发生,尤其是可降低输卵管因素、盆腔炎性疾病、子宫内膜因素引起的继发不孕,是一种简单、安全、有效的技术,值得临床推广。
Objective To observe the effect of hysteroscopy combined with desogestrel ethinyl estradiol in the prevention and treatment of secondary infertility after medical abortion. Methods A total of 800 patients who underwent curettage without curettage during May 2011 to May 2015 were enrolled in this study. They were randomly divided into trial group (n = 400) and control group (n = 400). The experimental group underwent hysteroscopy Surgery, postoperative administration of desogestrel ethinyl estradiol oral treatment; control group undergoing routine curettage. The incidence of secondary infertility and the causes of secondary infertility in two groups were compared. Results The rate of secondary infertility in trial group was 10.0% (40/400), which was lower than that in control group (15.0%, 60/400) (P <0.05). There was no significant difference in infertility rate between the two groups (P> 0.05), tubal factors, pelvic inflammatory disease and endometrial factors In the control group, the differences were statistically significant (P <0.05). Conclusion Hysteroscopic combined with desogestrel ethinyl estradiol in the treatment of incomplete abortion can effectively prevent the occurrence of postoperative secondary infertility, especially reduce the incidence of tubal factors, pelvic inflammatory disease, secondary infertility caused by endometrial factors , Is a simple, safe and effective technology that deserves clinical promotion.