宫腔镜下宫腔黏连分离术后3种预防再黏连方法的比较  

Comparison of three methods in preventing recurrent adhesion after transcervical resection of intrauterine adhesions

作　　者：李红娟[1] 王雅莉[1] 刘楠[1] 

机构地区：[1]郑州市中心医院妇产科,河南郑州450000

出　　处：《现代预防医学》2012年第10期2434-2435,共2页Modern Preventive Medicine

摘　　要：目的观察宫腔镜下分离宫腔黏连后3种预防再黏连方法的疗效。方法选择经宫腔镜诊断为宫腔黏连并成功分离黏连者108例,随机分为置环组、置环+人工周期组、几丁糖组,其中置环组为对照组,术后1个月宫腔镜下观察3组宫腔内黏连情况。结果Ⅰ、Ⅱ度黏连的患者,3组的再黏连率分别为10.00%、8.33%、7.69%(P﹥0.05),对Ⅲ度及以上黏连的患者,置环组的宫腔再黏连率为44.00%,高于后两组,且置环组肌性及结缔组织性黏连比例45.45%,高于后两组(P﹤0.05)。结论对于Ⅰ、Ⅱ度黏连的患者3种方法预防再黏连的疗效相同,而Ⅲ度及以上宫腔黏连的患者,术后应用置环+人工周期或几丁糖能显著减少术后宫腔再黏连的发生,较之单纯术后置环有明显的优势。OBJECTIVE To study the effect of three methods on preventing recurrent adhesion after transcervical resection of intrauterine adhesions.METHODS 108 patients with intrauterine adhension after transcervical resection were randomly divided into intrauterine contraceptive device（IUD）group（35 cases）,intrauterine contraceptive device（IUD）＋ artificial period treatment group（40 cases）and chitosan group（33 cases）,and the intrauterine contraceptive device（IUD）group were regarded as contrast group.The recurrent adhesion was observed through hysteroscopy one month later.RESULTS The recurrence rate of the adhesion of the patients withⅠandⅡdegree is 10.00%,8.33% and 7.69%,respectively（P﹥0.05）.The recurrence rate of the adhesion of the patients with Ⅲ degree（or above）which was 44.00% in IUD group was much higher than that of the other two groups（P﹤0.05）.Furthermore,the rate of the muscular adhension and connective-tissue adhension was 45.45% in IUD group,which was also much higher than that of the other two groups（P﹤0.05）.CONCLUSION The three methods have the same effect to the patients withⅠandⅡdegree intrauterine adhension.The application of intrauterine contraceptive device（IUD）＋ artificial period treatment or the chitosan can obviously decrease the recurrent adhesion after transcervical resection of Ⅲ degree or above intrauterine adhesions which has obvious advantages to the routine method of the contraceptive device application.

关 键 词：宫腔黏连 宫内节育器 人工周期 几丁糖 

分 类 号：R711[医药卫生—妇产科学]