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目的探讨人工流产术后月经异常的病因,进一步提出治疗方法。方法对23例人流后主诉月经异常的患者进行B超、性激素、宫腔镜检查;对宫腔粘连的病人行宫腔镜下分离粘连,放置宫内节育器,并行人工周期治疗。结果23例病人中宫腔粘连15例(65%),刮宫过度3例(13%),子宫内膜炎2例(8·7%),人流不全2例(8·7%),高泌乳血症1例(4·3%);15例宫腔粘连病人经治疗后,12例月经恢复,4例有生育要求者正常怀孕生育健康婴儿,3例因重度粘连,术后激素治疗无效,永久性闭经;3例刮宫过度者经放置节育器及人工周期治疗3个疗程,均恢复正常月经;1例宫腔镜检查内膜正常,内分泌结果提示高泌乳血症,经溴隐亭治疗半年后妊娠。结论人工流产术后月经异常的常见病因有宫腔粘连、刮宫过度等,对该类病人及早进行宫腔镜检查,明确病因,及早针对病因治疗,对保护其生育能力具有重要意义。
Objective To investigate the etiology of menstrual abnormalities after induced abortion and to propose further treatment methods. Methods Twenty-three patients with abnormal menstruation after abortion were examined with B-mode ultrasound, sex hormone and hysteroscopy. Hysteroscopy was performed on patients with intrauterine adhesions, and intrauterine devices were placed and intra-artificially treated. Results Among 23 patients, 15 cases (65%) had intrauterine adhesions, 3 cases (13%) had excessive curettage, 2 cases (8.7%) had endometritis, 2 cases (8.7% 1 case (3.4%) had blood disease; in 15 cases of intrauterine adhesions, 12 cases of menstruation recovered and 4 cases of normal pregnancy gave birth to healthy infants, 3 cases had severe adhesions and postoperative hormone therapy was ineffective, Permanent amenorrhea; 3 cases of curettage by placement of IUD and artificial cycle of treatment of three courses, were restored to normal menstruation; 1 case of endometrial examination of hysteroscopy, endocrine results prompted hyperprolactinemia, bromocriptine six months After pregnancy. Conclusions The common causes of menstrual abnormalities after induced abortion are intrauterine adhesions and excessive curettage. It is of great significance to hysteroscopy and early diagnosis of etiology in this group of patients with early etiological treatment.