地屈孕酮与黄体酮治疗先兆流产的临床疗效比较

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目的:比较地屈孕酮与黄体酮治疗先兆流产的临床效果。方法:选择宁海县妇幼保健院2015年3月至2017年5月收治的先兆流产患者50例为观察对象,采用随机数字表法分为对照组25例、观察组25例,对照组采用黄体酮治疗,观察组采用地屈孕酮治疗。比较两组激素水平变化、症状消失时间、保胎结果以及药物不良反应。结果:观察组治疗后1周孕酮、雌二醇、人绒毛膜促性腺激素分别为(112.65±6.35)nmol/L、(2 137.99±371.22)pmol/L、(4 261.54±245.55)IU/L,对照组分别为(101.56±5.32)nmol/L、(1 782.12±350.71)pmol/L、(3 642.26±210.20)IU/L,两组差异均有统计学意义(n t=6.694、3.484、9.581,均n P<0.05);观察组治疗后3周孕酮、雌二醇、人绒毛膜促性腺激素分别为(120.52±10.59)nmol/L、(2 240.68±409.06)pmol/L、(6 641.52±364.59)IU/L,对照组分别为(102.64±9.64)nmol/L、(1 921.76±371.07)pmol/L、(4 123.63±258.62)IU/L,两组差异均有统计学意义(n t=6.243、2.887、28.164,均n P<0.05);观察组治疗后5周孕酮、雌二醇、人绒毛膜促性腺激素分别为(134.15±17.16)nmol/L、(2 317.58±434.97)pmol/L、(8 456.51±459.52)IU/L,对照组分别为(109.56±8.54)nmol/L、(2 051.38±413.39)pmol/L、(6 416.36±261.31)IU/L,两组差异均有统计学意义(n t=6.414、2.218、19.297,均n P<0.05)。观察组腰部酸痛、腹部疼痛、阴道流血消失时间分别为(4.15±0.25)d、(3.10±0.52)d、(4.24±0.62)d,均短于对照组的(7.54±2.26)d、(4.31±1.10)d、(6.32±2.01)d(n t=7.455、4.972、4.944,均n P<0.01)。观察组保胎成功率为96.00%(24/25),高于对照组的72.00%(18/25)(χn 2=5.357,n P0.05)。n 结论:地屈孕酮治疗先兆流产的效果优于黄体酮。“,”Objective:To compare the clinical effect of dydrogesterone and progesterone in the treatment of threatened abortion.Methods:From March 2015 to May 2017, 50 patients with threatened abortion admitted in the Maternal and Child Health Hospital of Ninghai County were selected and randomly divided into two groups according to the digital table, with 25 cases in each group.The control group was treated with progesterone.The observation group was treated with dydrogesterone.The hormone levels, symptom disappearance time, fetal retention and adverse drug reactions were compared between the two groups.Results:One week after treatment, the levels of progesterone, estradiol and human chorionic gonadotropin in the observation group were (1 12.65±6.35)nmol/L, (2 137.99±371.22)pmol/L, (4 261.54±245.55)IU/L, respectively, which in the control group were (101.56±5.32)nmol/L, (1 782.12±350.71)pmol/L, (3 642.26±210.20)IU/L, respectively, the differences between the two groups were statistically significant (n t=6.694, 3.484, 9.581, all n P<0.05). Three weeks after treatment, the levels of progesterone, estradiol and human chorionic gonadotropin in the observation group were (120.52±10.59)nmol/L, (2 240.68±409.06)pmol/L, (102.64±9.64)nmol/L, and (6 641.52±364.59)IU/L, respectively, which in the control group were (102.64±9.64)nmol/L, (1 921.76±371.07)pmol/L, (4 123.63±258.62)IU/L, respectively, the differences between the two groups were statistically significant(n t=6.243, 2.887, 28.164, all n P<0.05). Five weeks after treatment, the levels of progesterone, estradiol and human chorionic gonadotropin in the observation group were (134.15±17.16)nmol/L, (2 317.58±434.97)pmol/L, and (8 456.51±459.52)IU/L, respectively, which in the control group were (109.56±8.54)nmol/L, (2 051.38±413.39)pmol/L, (6 416.36±261.31)IU/L, respectively, the differences between the two groups were statisticallysignificant (n t=6.414, 2.218, 19.297, all n P<0.05). The disappearance time of pain in the waist, abdominal pain and vaginal bleeding in the observation group was (4.15±0.25)d, (3.10±0.52)d, (4.24±0.62)d, respectively, which was shorter than that in the control group[(7.54±2.26)d, (4.31±1.10 d), (6.32±2.01)d](n t=7.455, 4.972, 4.944, all n P<0.01). The success rate of fetal preservation in the observation group was 96.00%(24/25), which was higher than that in the control group[72.00%(18/25)](χn 2=5.357, n P0.05).n Conclusion:The effect of dydrogesterone in the treatment of threatened abortion is better than progesterone.
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