首页|米非司酮配伍米索前列醇终止妊娠后子宫异常出血与术前凝血因子水平关系

米非司酮配伍米索前列醇终止妊娠后子宫异常出血与术前凝血因子水平关系

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目的:探究米非司酮配伍米索前列醇终止妊娠后子宫异常出血与术前凝血因子水平相关性.方法:选取2020年5月—2023年5月本院接诊自愿要求药物流产者88例,术前检测凝血因子,均给予口服米非司酮片+米索前列醇.分析药物流产后子宫异常出血情况并以此分为异常出血组(n=30)和非异常出血组(n=58),对比两组术前凝血因子水平,Spearman相关性分析子宫异常出血与术前凝血因子关系;受试者工作特征(ROC)曲线分析术前凝血因子水平对子宫异常出血的预测价值.结果:88例术后出血子宫异常出血率为34.1%;非异常出血组凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)均低于异常出血组,纤维蛋白原(FIB)水平高于异常出血组(均P<0.05);Spearman相关性分析,PT、APTT和TT与子宫异常出血存在正相关,FIB与子宫异常出血存在负相关(均P<0.001);PT、APTT、TT和FIB联合诊断药物流产后子宫异常出血的曲线下面积(0.913)高于各单独指标检测(0.716、0.799、0.788、0.815)(均P<0.05).结论:米非司酮配伍米索前列醇药物流产后子宫异常出血发生与女性术前凝血因子PT、APTT、TT和FIB之间具有相关性,且术前凝血因子PT、APTT、TT和FIB联合检测对药物流产后子宫异常出血有较高预测价值.
Correlation between the abnormal uterine bleeding of women with abortion by mifepristone combined with misoprostol and their levels of coagulation factors before termination of pregnancy
Objective:To explore the correlation between the abnormal uterine bleeding of women with medical abortion by mifepristone combined with misoprostol and their levels of coagulation factors before termination of pregnancy.Methods:A total of 88 women who wanted medical abortion voluntarily were given coagulation factors levels detected before termination of pregnancy from May 2020 to May 2023.These women were given oral mifepristone tablets com-bined with misoprostol for abortion.The abnormal uterine bleeding situationg of these women were analyzed and the women were divided into group A(30 women with abnormal bleeding)and group B(58 women with non-abnormal bleeding)according to the abnormal uterine bleeding occurrence or not.The coagulation factor levels of the women be-fore abortion was compared between the two groups.Spearman correlation analysis was conducted to analyze the corre-lation between the abnormal uterine bleeding of the women and their preoperative coagulation factors levels.Receiver operating characteristics(ROC)curve was used to analyze the value of the preoperative coagulation factor levels of the women for predicting their abnormal uterine bleeding.Results:The rate of the abnormal uterine bleeding of these 88 women with medical abortion was 34.1%.The values of prothrombin time(PT),activated partial thromboplastin time(APTT)and thrombin time(TT)of the women in group A were significantly lower than those of the women in group B,and the level of fibrinogen(FIB)of the women in group A was significantly higher(all P<0.05).Spearman correlation analysis showed that the values of PT,APTT and TT of the women were positively correlated with their abnormal uterine bleeding rate,and the FIB level of the women was negatively correlated with their abnormal uterine bleeding rate(all P<0.001).The area under the curve of the PT,APTT,and TT values combined with the FIB level of the women for diagnosing their abnormal uterine bleeding after medical abortion was 0.913,which was significantly higher than that(0.716)of the PT value,that(0.799)of the APTT value,that(0.788)of the TT value or that(0.815)of the FIB level alone(all P<0.05).Conclusion:The occurrence of the abnormal uterine bleeding of the women after medical abortion by mifepristone and misoprostol is correlated with their values of preoperative coagula-tion factors,such as PT,APTT,TT and FIB.The combined detection of the values of PT,APTT,TT and FIB of the women with medical abortion has higher predictive value for their abnormal uterine bleeding after abortion.

Medical abortionMifepristoneMisoprostolAbnormal uterine bleedingCoagulation factorCorrela-tionPredictive value

潘玮玮、徐琪、李芳

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安徽省蒙城县第二人民医院(233500)

安徽省亳州市人民医院

药物流产 米非司酮 米索前列醇 子宫异常出血 凝血因子 相关性 预测价值

2024

中国计划生育学杂志
国家人口计生委科学技术研究所

中国计划生育学杂志

CSTPCD
影响因子:1.759
ISSN:1004-8189
年,卷(期):2024.32(3)
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