神经肌肉电刺激对人工流产术后宫腔粘连及月经量减少的预防作用
Preventive Effect on Intrauterine Adhesions and Menstrual Volume Reduction by Neuromuscular Electrical Stimulation in Induced Abortion
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摘要: 目的 探讨神经肌肉电刺激对人工流产术后宫腔粘连 (IUA) 和月经过少的预防作用.方法 收集孕周<14周宫内妊娠且自愿接受人工流产术终止妊娠的人工流产妇女150例, 根据随机数字表法分为神经肌肉电刺激组、药物组和常规组, 每组50例.神经肌肉电刺激组用神经肌肉电刺激治疗;药物组口服妈富隆治疗.常规组患者未做任何特殊处理.观察3组患者术后3 d、术后15 d和第一次月经第3天时的血FSH、LH、E2、P值, 术后8 d、15 d时的子宫内膜厚度变化及IUA和月经过少的发生情况.结果 术后15 d时, 3组的FSH、LH、E2、P水平均较术后3 d时升高 (P<0.05) .第1次月经第3天时, 常规组FSH、LH、P明显高于术后3 d (P<0.05) .术后15 d和第一次月经第3天时, 药物组、神经肌肉电刺激组FSH、LH、P水平先升高后再降至术后3 d水平 (P<0.05) , E2则先升高后降至低于术后3 d水平 (P<0.05) .术后15 d, 药物组和神经肌肉电刺激组FSH、LH、E2、P水平比较差异不明显 (P>0.05) , 但均高于常规组;第一次月经第3天时, 药物组和神经肌肉电刺激组FSH、LH、E2、P水平比较差异不明显 (P>0.05) , 均低于常规组 (P<0.05) .神经肌肉电刺激组、药物组的IUA总发生率和月经过少发生率比较差异无统计学意义 (P>0.05) , 但均明显低于常规组 (P<0.05) .结论 人工流产术后给予神经肌肉电刺激治疗, 可有效改善术后低雌激素症状, 增加子宫内膜厚度, 预防IUA、月经过少, 其作用与妈富隆相当, 但无明显不良反应, 无药物带来的副作用, 安全有效, 且操作方便, 患者依从性好, 是人工流产术后预防IUA、月经过少发生的一个较好选择.Abstract: Objective To investigate the preventive effect on intrauterine adhesions (IUA) and scanty menstruation by neuromuscular electrical stimulationin induced abortion.Methods 150 pregnancy women with artificial abortion who had gestational age<14 weeks and voluntarily abortion termination pregnancy, according to random digital table method, they were divided into neuromuscular electrical stimulation group, drug group and routine group, there were 50 cases in each group.Patients in the neuromuscular electrical stimulation group were treated with neuromuscular electrical stimulation;patients in the drug group were treated with Marvelon Marvelon.Routine group were not done any special treatment.The blood FSH, LH, E2, P value at postoperative 3 days, 8 days and the first menstruation's 3 days, the endometrial thickness at postoperative 8 days, 15 days, the IUA and scanty menstruation among the three groups were observed.Results At postoperative 15 days, The FSH, LH, E2、P levels in the three group were significantly higher than those at 3 days after operation (P<0.05) .At the first time menstruation's 3 days, the FSH, LH, P levels in the routine group were significantly higher than those at 3 days after operation (P<0.05) .At postoperative 15 days, at the first time menstruation's 3 days, the FSH, LH, P levels in the drug group and in the neuromuscular electrical stimulation group increased firstly and then dropped to the level at3 days after operation (P<0.05) , the E2, P levels increased firstly and then decreased to the level which was lower than that at 3 days after operation (P<0.05) .At postoperative 15 days, the FSH, LH, E2, P level between the drug group and the neuromuscular electrical stimulation group were compared was not obvious (P>0.05) , but those were significantly higher than those in the routine group.At the first time menstruation's 3 days, the FSH, LH, E2, P level between the drug group and the neuromuscular electrical stimulation group were compared was not obvious (P>0.05) , but those were significantly lower than those in the routine group (P<0.05) .There was no significant difference in the total incidence of IUA and scanty menstruation between the neuromuscular electrical stimulation group and the drug group (P>0.05) , but they were significantly lower than those in the routine group (P<0.05) .Conclusions After artificial abortion, neuromuscular electrical stimulation can effectively improve the postoperative low estrogen symptoms, increase endometrial thickness, prevent IUA and scanty menstruation, its role is match to marvelon, but it has no obvious adverse reaction, no side effects caused by drugs, it is safe and effective, and easy to operate, patient compliance is good, it is a good choice to prevent the occurrence of IUA and scanty menstruation after artificial abortion.
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