宫腔镜下三种方法治疗宫腔粘连的疗效比较和分析  

The Comparison and analysis of the efficacy of three ways in treating intrauterine adhesions under hysteroscope

作　　者：朱伟艳[1,2] 成志[1,2] 吴海燕[1,2] 刘永珠[1,2] 陈北秀[1,2] 欧阳一兵[1,2] 

机构地区：[1]暨南大学附属清远医院 [2]清远市人民医院妇科二区,清远511500

出　　处：《妇产与遗传（电子版）》2014年第2期14-17,共4页Obstetrics-Gynecology and Genetics (Electronic Edition)

摘　　要：目的研究宫腔镜宫腔粘连电切术后放置宫内节育器、气囊双腔导尿管或几丁糖联合预防宫腔再粘连的疗效。方法回顾分析我院134例III型、IV型宫腔粘连行宫腔镜电切分离患者,术后采用3种不同方法防止宫腔粘连再发,其中A组40例,于宫腔镜电切分离术后放置宫内节育器联合补佳乐(戊酸雌二醇)和地屈孕酮治疗;B组56例,于宫腔镜电切分离术后放置气囊双腔导尿管联合补佳乐和地屈孕酮治疗;C组38例,于宫腔镜电切分离术后放置几丁糖联合补佳乐和地屈孕酮治疗。结果三组宫腔形态恢复情况,A组宫腔形态恢复有效率为80.0%,B组宫腔形态恢复有效率为94.6%,C组宫腔形态恢复有效率为81.6%,B组宫腔形态恢复有效率显著高于A、C组(P<0.05),有统计学意义;三组月经量恢复结果,A组月经恢复有效率为72.5%,B组月经恢复有效率为92.8%,C组月经恢复有效率为78.9%,B组月经量恢复率高于A组和C组,差异有统计学意义(P<0.05)。结论宫腔粘连术后放置气囊双腔导尿管联合补佳乐和地屈孕酮能更有效预防再粘连的发生。Objective To study the efficacy of treating intrauterine adhesions by placing intrauterinedevice, placing double balloon catheter or using chitosan after hysteroscopic electrocision in preventingrecurrence. Methods 134 cases of III and IV type intrauterine adhesions patients underwent hysteroscopicelectrocision and adopted three different ways to prevent recurrence were retrospectively analyzed. All thecases were divided into 3 groups: Group A(n=40): intrauterine device was placed after surgery, and patientswere treated with progynova(estradiol valerate) and dydrogesterone; Group B(n=56), double balloon catheterwas placed after surgery and patients were treated with progynova and dydrogesterone; Group C(n=38), chitosanwas placed after surgery and the patients were treated with progynova and dydrogesterone. Results Recovering conditions of intrauterine appearance in three groups are as following: effective rate of intrauterineappearance recovering in Group A is 80.0%, Group B is 94.6%, Group C is 81.6%, which shows a statisticalsignificance(P=0.045 and P<0.05); recovering results of menstrual cycle in three groups are as following: theeffective rate of menstrual cycle recovering in Group A is 72.5%, Group B is 92.8%, Group C is 86.8%, andGroup B is higher than Group A and Group C which exists a statistical significance(P<0.05). Conclusions Placing double balloon catheter combined with treatment of progynova and progesterone after hysteroscopicelectrocision has a better effectiveness in in preventing the recurrence of intrauterine adhesions.

关 键 词：宫腔粘连 节育器 气囊双腔导尿管 几丁糖 疗效 

分 类 号：R713.4[医药卫生—妇产科学]