目的 探讨早孕药物流产后即刻应用复方庚酸炔诺酮注射液对子宫恢复相关结局的影响。方法 采用双中心前瞻性队列研究设计，纳入2025年1月至2026年1月于复旦大学附属妇产科医院及徐州市妇幼保健院接受早孕药物流产且符合纳排标准的妇女139例。其中观察组69例，于药物流产后即刻注射复方庚酸炔诺酮注射液2 mL；对照组70例，流产后不使用任何激素避孕方法。比较两组药物流产后阴道流血持续时间、首次月经恢复时间、药物流产后2周及经后宫腔残留情况和清宫率。对药物流产后2周仍存在平均直径≤3 cm残留者进行亚组分析，并采用多因素logistic回归评估其转归的相关因素。结果 两组患者基线特征差异均无统计学意义。观察组首次月经恢复时间明显早于对照组[（25.51±6.77）d vs.（33.80±7.71）d，P<0.001]。观察组阴道流血持续时间≤2周的比例高于对照组（97.1% vs. 84.3%，P=0.021）。药物流产后2周复查时，观察组无宫腔残留比例高于对照组（44.9% vs. 27.1%，P=0.038），宫腔残留体积更小。经后复查，观察组无宫腔残留率显著高于对照组（76.8% vs. 55.7%，P=0.011）。观察组清宫率低于对照组（1.4% vs. 7.1%），但差异无统计学意义。在药物流产后2周仍存在平均直径≤3 cm残留者中，经后复查，观察组和对照组组内转阴率差异均有统计学意义（P<0.05）；随访结束时，观察组宫腔恢复正常比例高于对照组（59.5% vs. 43.5%）。多因素分析显示，阴道流血持续时间>2周与平均直径≤3 cm残留转阴概率降低相关（aOR 0.08，95%CI 0.01~0.68，P=0.021）。结论 早孕药物流产后即刻应用复方庚酸炔诺酮注射液，阴道流血持续时间短、月经恢复快、宫腔残留更小、经后宫腔恢复正常比例更高。在落实流产后避孕的同时，该方案可能对药物流产后的宫腔恢复具有额外获益。

Objective To investigate the effect of immediate administration of compound norethisterone enanthate injection after medical abortion in early pregnancy on uterine recovery-related outcomes. Methods A dual-center，prospective cohort study design was adopted，enrolling 139 patients who underwent early-pregnancy medical abortion at the Obstetrics and Gynecology Hospital of Fudan University and Xuzhou Maternal and Child Health Hospital between January 2025 and January 2026 and met the inclusion and exclusion criteria. The observation group（n=69）received 2 mL of compound norethisterone enanthate injection immediately after medical abortion；the control group（n=70）did not use any hormonal contraception after abortion. The duration of vaginal bleeding after medical abortion，time to first menstruation，residual uterine tissue at 2 weeks after medical abortion，and curettage rate were compared between the two groups. Subgroup analysis was performed on patients with residual tissue of average diameter ≤3 cm at 2 weeks after-abortion，and multivariate logistic regression was used to assess the relevant factors for their outcome. Results There were no statistically significant differences in baseline characteristics between the two groups. The first menstrual period returned significantly earlier in the observation group than in the control group [（25.51±6.77）days vs.（33.80±7.71）days，P<0.001]. The proportion of vaginal bleeding lasting ≤2 weeks was higher in the observation group than in the control group（97.1% vs. 84.3%，P=0.021）. At the 2-week follow-up after medical abortion，the proportion of no retained products of conception was higher in the observation group than in the control group（44.9% vs. 27.1%，P=0.038），and the retained product volume was smaller. At the post-menstrual follow-up，the rate of no retained products of conception was significantly higher in the observation group than in the control group（76.8% vs. 55.7%，P=0.011）. The curettage rate was lower in the observation group than in the control group（1.4% vs. 7.1%），but the difference was not statistically significant. In patients with residual tissue of average diameter ≤3 cm at two weeks after medical abortion，the negative conversion rate was statistically significant in both the observation and control groups upon follow-up（P<0.05）. At the end of follow-up，the proportion of patients with normal uterine cavity recovery was higher in the observation group than in the control group（59.5% vs. 43.5%）. Multivariate analysis showed that vaginal bleeding duration >2 weeks was associated with a decreased probability of negative conversion of residual tissue of average diameter ≤3 cm（aOR 0.08，95%CI 0.01-0.68，P=0.021）. Conclusions Immediate administration of compound norethisterone enanthate injection in early pregnancy after medical abortion results in shorter duration of vaginal bleeding，faster menstrual recovery，smaller residual tissue，and a higher proportion of normal uterine cavity recovery after menstruation. This regimen may provide additional benefits to uterine cavity recovery after medical abortion in addition to implementing post-abortion contraception.