宫腔粘连术后留置玻璃酸钠联合大剂量雌激素预防再发粘连  

Intrauterinely Detained Sodium Hyaluronate and Oral Large Dose Estrogen Against Recurrence of Intrauterine Adhesions after Transcervical Release of Adhesions

作　　者：刘超斌[1] 谢熙[1] 苏彦钊[1] 易劲松[1] 周炎珍[1] 王玉兰 

机构地区：[1]福建省妇幼保健院,福州350001 [2]福建省长乐市医院,长乐350200

出　　处：《生殖与避孕》2014年第3期210-214,252,共6页Reproduction and Contraception

基　　金：福建省临床重点专科建设项目专项基金资助;项目号:闽财指20121589

摘　　要：目的:观察宫腔粘连(IUA)分解术后宫腔内放入玻璃酸钠联合大剂量雌激素口服预防再粘连的效果。方法:宫腔镜确诊为IUA患者272例,分为A组和B组,A组(n=103)行宫腔镜下IUA分离术及宫腔内节育器(IUD)放置术,术后口服大剂量雌激素及孕激素人工周期3个月;B组(n=169)在A组相同治疗的基础上加宫腔内留置玻璃酸钠;比较A组和B组的疗效。结果:中度粘连患者术后粘连再发率B组显著低于A组(P<0.05);A、B组的治疗有效率分别为:轻度粘连100%、100%;中度粘连83.3%、94.6%;重度粘连68.2%、83.9%(P均>0.05);轻、中度IUA的治愈率B组显著高于A组(P<0.05)。结论:IUA分解术后宫腔内留置玻璃酸钠联合大剂量雌激素口服可提高预防再粘连的效果,特别对轻、中度IUA效果显著。Objective： To investigate the effects of intrauterine sodium hyaluronate coupled with oral large dose of oral estrogen on prevention of recurrent intrauterine adhesions （IUA） after transcervical release of adhesions （TCRA）. Methods： Totally 272 cases, which were finally diagnosed as IUA and underwent hysteroscopy during hospitalization, were enrolled. Among them 103 cases （group A） were orally administered with large dose of progynova and progestogen for 3-month artificial cycles, and the other 169 cases （group B） were treated as the same as group A with the exception of addition of intrauterinely detained sodium hyaluronate post-operatively for 3 d. Efficacy between the two groups was compared. Results： The recurrence rates for post-operative adhesions were significantly lowered in group B compared with group A regarding moderate IUA （P〈0.05）. The overall effective rates （cured ＋ effective efficacy） for groups A and B were shown as following： 100% and 100% for mild IUA, 83.3% and 94.6% for moderate IUA, and 68.2% and 83.9% for severe IUA （all P〉0.05）. For mild and moderate IUA, significantly increased cure rates were indicated in group B versus group A （P〈0.05）. Conclusion： Addition of intrauterinely detained sodium hyaluronate, coupled with large dose of oral estrogen, is effective on prevention of recurrent IUA especially in the mild and moderate types after TCRA.

关 键 词：宫腔粘连 玻璃酸钠 雌激素 术后再粘连 

分 类 号：R713.4[医药卫生—妇产科学]