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目的观察人工流产术后应用复方口服避孕药(COC)对出血天数、并发症、月经复潮时间等的影响以及患者依从性,探讨其临床应用价值。方法自2009年2月至2010年8月,符合本研究纳入标准的人工流产300例,随机分为术后口服炔雌醇去氧孕烯组(A组,106例)、炔雌醇环丙孕酮组(B组,96例)和对照组(C组,98例),A组和B组分别于术后当天开始予以口服相应药物。随访期内观察患者术后出血天数、月经复潮时间、感染率、再次计划外妊娠率,评价用药依从性。结果 A组和B组的术后出血时间和月经复潮时间低于C组,差异有统计学意义(P<0.05)。未坚持用药者与C组共169例中有15例发生意外妊娠,意外妊娠率为8.9%。坚持服药至本研究终点的78例中无发生不良心血管事件及其他严重不良事件。坚持1个周期的女性占入组的73.8%(149/202),但是继续用药者仅占入组时的38.6%(78/202)。担心COC影响体重是女性未能坚持服药的最主要因素。结论人流术后应用COC可以减少术后出血、盆腔感染,缩短术后月经复潮时间,坚持使用可降低再次意外妊娠的风险。由于对COC认识存在误区,患者用药依从性不高。
Objective To observe the effect of compound oral contraceptive (COC) on the number of bleeding days, complications, menstrual rewet time and the compliance of patients after abortion, and to explore its clinical value. Methods From February 2009 to August 2010, 300 cases of induced abortion complying with the criteria of this study were randomly divided into ethinyl estradiol, desogestrel group (group A, 106 cases), ethinylestradiol, cyclopropane Progesterone group (group B, n = 96) and control group (group C, n = 98). Group A and group B were orally administered the corresponding drugs on the day after the operation. During the follow-up period, the postoperative bleeding days, menstrual period, infection rate, again planning the pregnancy rate were evaluated, and the medication compliance was evaluated. Results The postoperative bleeding time and menstruation recuperation time in group A and group B were lower than those in group C, with statistical significance (P <0.05). Unconscious medication and C group, a total of 169 cases in 15 cases of unplanned pregnancy, 8.9% of the accidental pregnancy rate. No adverse cardiovascular events and other serious adverse events persisted in 78 of the 78 patients who took the medication until the end of the study. Women who stayed one cycle accounted for 73.8% (149/202) of the enrollment group, but continued use only accounted for 38.6% (78/202) of the enrollment group. Fear of COC affecting weight is the most important factor that women fail to adhere to medication. Conclusions The application of COC after abortion can reduce postoperative bleeding, pelvic infection, shorten the postoperative period of menstruation re-tide, adhere to reduce the risk of re-unexpected pregnancy. Due to the misunderstanding of COC, patients with drug compliance is not high.