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目的探讨宫腔镜技术在稽留流产清宫和随访中的临床价值。方法稽留流产待清宫患者128例,随机分为观察组和对照组,各64例。两组均给予预处理:口服3 mg补佳乐,3次/d,共3 d;1 d后口服50 mg米非司酮,2次/d,共2 d;观察组:于第4天行宫腔镜下清宫手术;对照组:于第4天晨7:00口服米索前列醇600μg(或放置于阴道后穹窿),2~3 h后行常规清宫手术。两组患者于术后第1次月经来潮干净3~7 d(月经未来潮者术后30 d)再次复查宫腔镜。比较两组患者手术时间、术中出血量、术后阴道流血时间、宫腔镜随访术后宫腔残留、宫腔粘连及经量改变例数。结果观察组流血时间明显短于对照组,差异有统计学意义(P<0.05)。两组手术时间、术中出血量相比差异无统计学意义(P>0.05)。宫腔残留、宫腔粘连、经量改变例数等观察组均低于对照组,差异有统计学意义(P<0.05)。结论宫腔镜技术在稽留流产清宫和随访中有很大的临床价值。
Objective To investigate the clinical value of hysteroscopy in abortion and follow-up of missed abortion. Methods 128 cases of abortion pending abortion, were randomly divided into observation group and control group, each 64 cases. Two groups were given pretreatment: oral 3 mg norepinephrine, 3 times / d, a total of 3 d; 1 d after oral administration of 50 mg of mifepristone, 2 times / d, a total of 2 d; observation group: on the 4th day Hysteroscopic surgery under hysteroscopy was performed. In the control group, 600 μg of misoprostol (or vaginal fornix) was orally administered at 7:00 on the 4th day and was routinely cured after 2 to 3 hours. Two groups of patients in the first postoperative menstrual cramps clean 3 ~ 7 d (30 days after menorrhagia after surgery) to review the hysteroscopy again. The operation time, intraoperative blood loss, postoperative vaginal bleeding time, uterine cavity residual after hysteroscopy follow-up, intrauterine adhesions and the changes of the amount of cases were compared between the two groups. Results The bleeding time of the observation group was significantly shorter than that of the control group, with a significant difference (P <0.05). There was no significant difference in operative time and blood loss between the two groups (P> 0.05). Intrauterine residue, intrauterine adhesions, the amount of change in the number of cases were observed in the observation group were lower than the control group, the difference was statistically significant (P <0.05). Conclusion Hysteroscopy in missed abortion and follow-up have a great clinical value.