论著

影响不全流产期待治疗效果的相关因素分析

Analysis of factors associated with the effect of expectant treatment of incomplete abortion

:34-38
 
目的 探讨影响宫腔修复的因素,为不全流产妇女选择期待治疗提供理论依据。方法 2021年1月—12月在香港大学深圳医院招募早孕药流不全的患者534例,记录其人口学特征以及从排胎到流产后3周到月经复潮后的相关情况,通过多因素Logistic回归分析影响不全流产者宫腔修复的因素。结果 534例药流不全患者中,月经复潮后宫腔残留240例,残留率为44.9%;多因素Logistic回归分析显示,BMI(OR=0.888,95%CI:0.808~0.975)、子宫位置(OR=1.836,95%CI:1.139~2.958)、人工流产次数(OR=2.258,95%CI:1.078~4.728)、阴道流血时长(OR=0.344,95%CI:0.141~0.837)、残留物最大径线(OR=1.061,95%CI:1.031~1.092)、残留物血流信号2级/3级(OR=3.636,95%CI:1.790~7.394;OR=4.001,95%CI:1.561~10.256)是宫腔残留的影响因素。结论 宫腔残留的高危因素有子宫后位、残留物最大径线、1次以上的人工流产、2级及以上的残留物血流信号,且血流信号等级影响最大。BMI和阴道流血时长>3周是宫腔残留的保护因素。
Objective To investigate the factors affecting uterine cavity repair and to provide a theoretical basis for the choice of expectant treatment for women with incomplete abortion.Methods From January to December 2021,534 patients with incomplete abortions were recruited at University of Hong Kong-Shenzhen Hospital,and their demographic characteristics and correlations from expulsion of the gestational sac to 3 weeks after medication abortion and after menstrual resumption were recorded,and the factors affecting uterine cavity repair in incomplete abortions were analyzed by multifactorial logistic regression.Results In 534 women,there were 240 cases of uterine cavity remnants after menstrual return,with a remnant rate of 44.9%;the results of multifactorial logistic regression analysis showed that BMI(OR=0.888,95% CI:0.808-0.975),uterine position(OR=1.836,95% CI:1.139-2.958),number of abortions(OR=2.258,95% CI:1.078-4.728),length of vaginal bleeding(OR=0.344,95% CI:0.141-0.837),maximum diameter of residuals(OR=1.061,95% CI:1.031-1.092),and residual blood flow signal grade 2/3(OR=3.636,95% CI:1.790-7.394;OR=4.001,95%CI:1.561-10.256)were influential factors for uterine residuals.Conclusions High-risk factors for uterine residuals are posterior uterus,the maximum diameter of residuals,more than one abortion,grade 2 or higher residual blood flow signal,and the grade of blood flow signal had the greatest effect.BMI and duration of vaginal bleeding >3 weeks are protective factors for uterine residuals.
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