臨床研究
黃體酮膠囊聯合地屈孕酮片治療先兆流產的療效觀察
徐陽
【摘要】 【摘要】目的 分析探究黃體酮膠囊聯合地屈孕酮片治療先兆流產的療效。方法 本次將我院在2018年1月~12月收治的80例先兆流產患者視為研究的主對象，進一步以隨機數字表法分成兩個不同的組別，每組平均為40例；其中對照組患者給予黃體酮膠囊治療，觀察組患者給予黃體酮膠囊聯合地屈孕酮片，對比兩組用藥效果及安全性。
【關鍵字】 黃體酮膠囊,地屈孕酮片,治療,先兆流產,療效
中圖分類號：文獻標識碼：文章編號：
[Abstract] Objective To analyze the effect of progesterone capsule combined with didrogesterone tablet in the treatment of threatened abortion. Methods 80 cases of threatened abortion patients admitted to our hospital from January to December 2018 were regarded as the main subjects of the study. They were further divided into two groups by random number table method, with an average of 40 cases in each group. The patients in the control group were treated with progesterone capsule, while those in the observation group were treated with progesterone capsule combined with didrogesterone tablet. The efficacy and safety of the two groups were compared. Results (1) The time of waist pain, lower abdominal pain, vaginal bleeding elimination in the observation group was significantly shorter than that in the control group, and there were significant statistical differences between the two groups. (2) Before treatment, there was no significant difference in progesterone level between the two groups (P>0.05); after treatment, the progesterone level in the observation group was significantly higher than that in the control group, and there was a significant difference between the two groups (P<0.05). (3) The total incidence of adverse reactions in the observation group was 7.50%, which was significantly lower than 27.50% in the control group. There was a significant difference between the two groups (P<0.05), with statistical significance. (4) In terms of the success rate of fetal protection, 97.50% of the observation group was significantly higher than 82.50% of the control group, and the data between the two groups had the value of statistical research (P<0.05). Conclusion Progesterone capsule combined with Didrogesterone Tablet is effective in the treatment of threatened abortion, with high success rate of fetal protection and slight side effects. Therefore, it is worth popularizing in clinical practice.
流產是指在妊娠不足28周、胎兒體質量不足1 kg而終止妊娠的活動，根據其發展進程可分為先兆流產、難免流產、不全流產、完全流產、過期流產5種類型[1]。先兆流產（threatened abortion）是一種有可能發展為流產的病癥，孕婦在妊娠不超過28周時，由于染色體異常、內分泌異常、嚴重營養缺乏以及吸煙酗酒等不良習慣，出現陰道少量流血、陣發性下腹痛或腰痛等癥狀，經檢查子宮大小與孕周一致，宮口未開且胎膜完整，無妊娠物排出，如若及時予以對癥治療，采取保胎措施，可繼續妊娠[2]。所以，為了保證先兆流產患者的生命安全，有必要給予有效的治療方法。此次將我院在2018年1月至2018年12月收治的80例先兆流產患者作為研究的對象，其目的是分析探究黃體酮膠囊聯合地屈孕酮片治療先兆流產的效果，涉及的研究成果如下。
1 資料與方法
1.1 一般資料：本次將我院在2018年1~12月收治的80例先兆流產患者視為研究的主對象，進一步以隨機數字表法分成兩個不同的組別，每組平均為40例。其中，對照組40例中，最小、最大年齡分別為22、41歲，中位數年齡（29.12±2.43）歲；妊娠時間為5~11周，平均為（8.93±1.25）周；其中，初產婦18例，經產婦22例；②觀察組40例中，最小、最大年齡分別為23、42歲，中位數年齡（28.76±2.27）歲；妊娠時間為5~12周，平均為（9.05±1.13）周；其中，初產婦19例，經產婦21例。由一般資料可知，兩組比較均沒有明顯差異，P＞0.05，代表兩組有比較的意義。
1.2 入選和排除標準：入選標準：①患者經產科檢查確診為先兆流產，尿妊娠試驗呈陽性，在臨床上表現為陰道少量出血、腰部酸痛、下腹部陣發性疼痛等癥狀；②此次試驗在醫院所屬醫學倫理委員會監理下展開，患者知悉對照組、觀察組治療方案后，自愿參與，簽署知情同意書后納入研究[3]。排除標準：①合并有心、肝、腎等嚴重器質病變患者；②習慣性流產患者；③黃體酮膠囊、地屈孕酮片過敏患者[4]。
1.3 治療方法：對照組給予黃體酮膠囊醫治，即：使用黃體酮膠囊（浙江仙琚制藥股份有限公司，國藥準字H20041902），每12 h服藥1次，100毫克/次，連續服藥2周，口服。觀察組給予黃體酮膠囊聯合地屈孕酮片，在對照組基礎上加服地屈孕酮片（Abbott Biologicals B.V.(荷蘭)，國藥準字H20110211），每日1次，初始劑量為40毫克/次，隨后可隨著并且改善調節為每日2次，10毫克/次，連續服藥2周。治療期間，患者應臥床休養，給予吸氧及常規營養支持，加強心理護理干預，保持身心愉悅，禁止性生活。療程結束后，對比兩組臨床療效。