| [Objectives]To study the Drospirenone and Ethinylestradiol Tablets application effect on endometrial repair in patients with missed abortion curettage after surgery,as well as for the prevention of uterine adhesions after surgery,evaluate the clinical value of Drospirenone and Ethinylestradiol Tablets,in order to provide some references for clinical treatment.[Methods]1.91 cases of missed abortion patients were chosen in the First People’s Hospital of Zhangjiagang in July 2013～2017.All met the inclusion criteria and exclusion criteria,age 22 to 38 years old,mean age(29.5±3.5)years old,The average number of pregnancies(2.02±0.75)and missed abortions(2±1).according to the admission order using the random number table method to divide them into study group and control group.There were 46 patients in the study group and 45 patients in the control group.There was no significant difference in the general data and medical history between the two groups(P>0.05),which was comparable.The study was carried out after it was approved by the Ethics Committee of our hospital.All patients signed the study informed consent.2.Both groups of patients received ultrasound-guided missed abortion curettage.Both groups of operation and nursing staff were members of the same team.Patients were treated with pre-operative fetal therapy,given mifepristone 50mg bid after 2 consecutive days of abdomen or eating 2h,fasted 2h after taking medicine,and took misoprostol 0.6 mg on the third day.After embryo tissue was discharged,the missed abortion curettage was conducted under ultrasound guidance according to the operation requirements.Patients in the control group were given routine treatment and nursing after operation,including hemostasis and analgesia,prevention of infection,systematic preaching and health education.Patients in the study group were given orally the standard Chinese medicine J 2013 01 20(each tablet containing ethinylestradiol 0.03 mg and drospirenone 3 mg)on a daily basis and 21 days as a course of treatment after operation on the basis of routine treatment and nursing.After the end of one course of treatment,the drug was stopped for seven days,and then the next course of treatment was carried out.There were two courses of treatment.3.The patients were followed up for 6 months,and the vaginal bleeding was observed and recorded,including the vaginal bleeding time and the amount of vaginal bleeding.Menstrual recovery time and endometrial thickness were measured by B-mode ultrasound on the 14th day after operation.The time of urine HCG turning negative;After 6 months follow-up,hysteroscopy was performed to examine intrauterine adhesions,including mild adhesions,moderate adhesions and severe adhesions.The occurrence of adverse reactions.[Results]1.In terms of postoperative vaginal bleeding time,postoperative vaginal bleeding,the average vaginal bleeding time of the study group was(6.1±0.7)days,and the average vaginal bleeding time of the control group was(8.1±2.3)days.The vaginal bleeding time of the study group was shorter than that of the control group.The difference was statistically significant,P<0.05.In terms of vaginal bleeding,40 patients in the study group had less bleeding than menstrual volume,4 patients had bleeding volume equal to menstrual volume,and 2 patients had more bleeding than menstrual volume;There were 32 patients with bleeding less than menstrual volume,8 patients with bleeding volume equal to menstrual volume,5 patients with more bleeding than menstrual volume,and the study group had less vaginal bleeding than the control group,the difference was statistically significant,P>0.05.2.In terms of menstrual recovery time,the average menstrual recovery time of the study group was(26.3±2.6)days,and the average menstrual recovery time of the control group was(35.7±4.1)days.Compared with the two groups,the menstrual recovery of the study group was earlier.The difference was statistically significant(P<0.05).In the 14-day postoperative period,the average endometrial thickness of the study group was(9.0±1.3)mm,and the mean endometrial thickness of the control group was(6.1±).1.1)mm,compared with the two groups,the endometrial thickness of the study group was higher than the control group 14 days after surgery,the difference was statistically significant,P<0.05.3.One month after the operation,the HCG negative turnover rate was observed in 36 cases(78.26%)in 2 weeks in the study group,45 cases(97.82%)in 3 weeks in the study group,46 cases(100%)in 4 weeks in the study group,,24 cases(53.33%)in 2 weeks in the control group,44 cases(97.78%)in 3 weeks in the study group,and 44 cases(97.78%)in 4 weeks in the control group.the difference between the two groups was statistically significant(p<0.05).4.In terms of postoperative intrauterine adhesions,the study group had no adhesions in 29 cases(63.04%),mild adhesions in 11 cases(23.91%),moderate adhesions in 5 cases(10.87%),severe adhesions in 1 case(2.17%)and total adhesions in 36.96%.In the control group,there were 19 cases without adhesion,accounting for 42.22%,16 cases with mild adhesion,accounting for 35.56%,7 cases with moderate adhesion,accounting for 15.57%,3 cases with severe adhesion,accounting for 6.67%,and the total adhesion rate was 57.78%.Compared with the two groups,the intrauterine adhesions in the study group were less than those in the control group,and the difference was statistically significant(p<0.05).5.In terms of adverse reactions,the study group had 1 depression/depression,1 migraine,1 nausea,4 breast pain,and a total incidence of adverse reactions of 15.22%;1 depression/depression in the control group 1 case of migraine,0 cases of nausea,1 case of breast pain,the total incidence of adverse reactions was 6.67%.The difference between the two groups was statistically significant(P<0.05).The incidence of adverse reactions was higher in the study group.[Conclusions]The administration of drospirenone ethinylestradiol tablets after missed abortion and curettage is conducive to the restoration of endometrium after surgery,reducing postoperative bleeding,accelerating recovery of menstrual cycle,accelerating the time of HCG turning negative in urine,and has good performance in preventing intrauterine adhesions.Occasionally,there are mild adverse reactions,and the clinical application effect is good.It is recommended to promote clinical use. |
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