透明质酸钠膜贴预防宫腔镜电切术后宫腔粘连的疗效观察  

Effect Observation of Prevention of Intrauterine Adhesion's Formation by Sodium Hyaluronate Film after Hysteroscopic Electrosurgery

作　　者：宫凤艳[1] 苑春莉[1] 刘淑芹[1] 许为[2] 

机构地区：[1]吉林大学第一医院妇产科,吉林省长春市130021 [2]吉林大学第二医院妇产科

出　　处：《中国全科医学》2010年第30期3434-3436,共3页Chinese General Practice

摘　　要：目的观察透明质酸钠膜贴对宫腔镜电切术后宫腔粘连的预防效果及安全性。方法收集在吉林大学第二临床医院2006年3月—2008年1月随访到的完整病例76例,其中观察组38例,宫腔镜电切术后宫腔内置入透明质酸钠膜贴;对照组38例,宫腔镜电切术后常规处理。患者分别于术后1个月、3个月行门诊宫腔镜复查,评价宫腔粘连的发生率、粘连的类型、粘连的程度及其创面愈合情况。结果 (1)术后1个月观察组和对照组的宫腔粘连发生率分别为10.5%(4/38)和65.8%(25/38),差异有统计学意义(P<0.05);术后3个月观察组和对照组的宫腔粘连发生率分别为18.4%(7/38)和68.4%(26/38),差异有统计学意义(P<0.05)。(2)术后1个月、术后3个月两组发生宫腔粘连的类型及粘连程度:观察组无粘连或发生膜性粘连,对照组易发生粘连且粘连程度较重。(3)创面<1/2宫腔者粘连发生率为11.8%(4/34),创面≥1/2宫腔者粘连发生率为59.5%(25/42),二者比较差异有统计学意义(P<0.01)。结论宫腔镜电切术后应用透明质酸钠膜贴能减少粘连发生率,减轻粘连程度,近期疗效优于远期。患者术后宫腔粘连的程度与宫腔内手术创伤面积大小有关。Objective To assess the effect and safety of sodium hyaluronate membrane sticker on preventing intrauterine adhesion（IUA） after hysteroscopic resection.Methods Collect 76 cases surveyed during the period from March 2006 to January 2008.The observation group includes 38 cases,which were put sodium hyaluronate membrane sticker into uterine after hysteroscopic resection,while 38 cases in the control group not.Then the re-examination of hysteroscopy was performed a month and three months later to evaluate adhesion incidence,types and degree as well as healing of resected area.Results （1） Incidence of IUA of observation group and control group after one month were 10.5%（4/38） and 65.8%（25/38） respectively,and the difference was significant（P0.05）;Incidence of IUA of observation group and control group after three months were 18.4%（7/38） and 68.4%（26/38） respectively,and the difference was significant（P0.05）.（2）When comes to the adhesion types and degree of the two groups after one month and three months,no adhesion or only endometrial adhesion occurred in observation group,while adhesion in control group was more severe.（3） Incidence of IUA was 11.8% in those whose resected area1/2 cavity,while incidence of IUA was 59.5% in those whose resected area≥1/2,the difference was significant（P0.01）.Conclusion （1）Hyaluronic acid film can effectively reduce IUA,the short-term effect is more notable than long-term effect.（2）Incidence of IUA is related to the resected area.

关 键 词：宫腔粘连 宫腔镜检查 透明质酸 

分 类 号：R714.2[医药卫生—妇产科学]