目的 探讨雌二醇凝胶在重复人工流产术后应用的临床效果。方法 回顾性分析2023年1—12月在江南大学附属妇产医院（无锡市妇幼保健院）行人工流产术的妇女127例，根据术后治疗方法分为基础治疗组、雌二醇凝胶组和避孕药组，每组分别为45、40和42例。3组妇女人工流产次数均≥2次，均行负压吸引人工流产手术。基础治疗组予益母草、头孢地尼口服1周；雌二醇凝胶组在基础治疗组用药基础上，术后当日开始经皮涂抹雌二醇凝胶，持续28 d（月经来潮停用）；避孕药组在基础治疗组用药基础上，术后当日开始口服屈螺酮炔雌醇片（Ⅱ），持续28 d，比较3组治疗7、21 d后子宫内膜厚度，术后阴道流血时间，恢复首次月经时间，肝肾功能、并发症及不良反应发生情况。结果 雌二醇凝胶组治疗后7、21 d子宫内膜厚度高于避孕药组及基础治疗组，差异有统计学意义（P<0.05）。雌二醇凝胶组术后阴道流血时间短于避孕药组及基础治疗组，宫腔积液发生率、月经量减少发生率低（P<0. 05）。避孕药组恢复首次月经时间短于雌二醇凝胶组及基础治疗组（P<0.05），雌二醇组月经复潮时间与术前月经周期无差异，基础治疗组月经复潮时间延长。3组宫腔残留发生率、肝肾功能比较差异无统计学意义（P>0.05）。结论 经皮雌二醇凝胶对人工流产术后子宫内膜恢复效果优于口服屈螺酮炔雌醇片（Ⅱ）及自然恢复者，预后良好，且药物并发症及不良反应少。

Objective To explore the clinical effect of applying estradiol gel after repeated induced abortion. Methods A total of 127 women who underwent induced abortion in Jiangnan University Affiliated Maternal and Child Health Hospital（Wuxi Maternal and Child Health Hospital）from January 2023 to December 2023 were retrospectively analyzed，and they were divided into basic treatment group，estradiol gel group and contraceptive group according to postoperative treatment methods，with 45 cases，40 cases and 42 cases in each group.The average number of induced abortion in the 3 groups was ≥2 times，and all groups received induced abortion with negative pressure suction. The basic treatment group was given oral administration of Leonurus and cefdinir for 1 week. On this basis，the estradiol gel group was given percutaneous application of estradiol gel for 28 days starting from the day receiving surgery （it was stopped during menstrual period），and the contraceptive group was given oral administration of drospirosterone ethinylestradiol tablets （Ⅱ） for 28 days starting from the day receiving surgery. The endometrial thickness，duration of postoperative vaginal bleeding，recovery time of first menstruation，liver and kidney function，complications and adverse reactions were compared among the three groups after 7 and 21 days of treatment. Results The endometrial thickness of estradiol gel group was higher than that of contraceptive group and basic treatment group at 7 and 21 days after treatment，and the difference was statistically significant （P< 0.05）. The duration of postoperative vaginal bleeding in estradiol gel group was shorter than that in contraceptive group and basic treatment control group，and the incidence of uterine effusion and decreased menstrual volume was lower （P< 0.05）. The recovery time of first menstruation in the contraceptive group was shorter than that in the estradiol gel group and the basic treatment group （P < 0.05）. There was no difference between the time of menstruation after recovery and the pre-operative menstruation cycle in the estradiol group，and the time of menstruation after recovery in the basic treatment group was prolonged. There were no significant differences in the incidence of uterine cavity residue or liver and kidney function among the three groups（P>0.05）. Conclusion The effect of percutaneous estradiol gel on endometrial recovery after induced abortion is better than that of oral drospiroone ethoestradiol tablets and natural recovery，with good prognosis and fewer drug complications and adverse reactions.