不同剂量戊酸雌二醇预防宫腔粘连48例临床效果分析  

Clinical Analysis of Different Doses of Estradiol Valerate to Prevent Intrauterine Adhesions in 48 Cases

作　　者：王晶[1] 陈滢[1] 童明[1] 

机构地区：[1]广州军区武汉总医院妇产科,湖北武汉430070

出　　处：《华南国防医学杂志》2014年第4期312-313,359,共3页Military Medical Journal of South China

基　　金：湖北省人口和计划生育委员会科研课题(JS-2012009)

摘　　要：目的探讨不同剂量戊酸雌二醇预防宫腔粘连(intrauterine adhesion,IUA)的临床效果。方法 48例IUA患者作为研究对象,给予宫腔镜检查诊断并成功行宫腔镜手术分离粘连,随后给予口服不同剂量(2 mg/d、6 mg/d与9mg/d)戊酸雌二醇治疗。结果①病变程度按March分类:轻度15例,中度24例,重度9例。②手术总有效率为95.83%,其中轻、中度患者均有效,且三个剂量组临床效果无明显差异,而重度患者有2例治疗无效,为中、小剂量组各1例,且9 mg/d组与2 mg/d、6 mg/d组相比:子宫内膜厚度及月经量明显增加,差异有统计学意义。结论对于轻、中度IUA患者,术后给予口服小剂量戊酸雌二醇治疗即可达到理想治疗效果,具有小剂量优势;而重度患者应用大剂量雌激素,可明显改善IUA预后,同时并不增加药物副作用。Objective To investigate the clinical results of different doses of estradiol valerate to prevent intrauterine adhesions. Methods A total of 48 patients with intrauterine adhesions were researched. Adhesions were successfully separated by diagnostic hysteroscopy and hysteroscopic surgery. Different doses of estradiol valerate were orally administrated. Results According to the March severity classification,15 cases were mild,24 cases were moderate and 9 cases were severe. The total effective rate was 95. 83 %. The mild and moderate patients were all effectively cured. There was no significant difference in clinical outcomes among the three dose groups. There was no treatment effect in one severe patient in low-dose group and another in middle-dose group. Compared with 2 mg / d and 6 mg / d group,the endometrial thickness and menstrual flow were increased significantly in 9 mg / d group. Conclusion The mild and moderate cases with intrauterine adhesions can be treated effectively with postoperative low-dose oral estradiol valerate administration,which has low-dose superiority. Severe patients can be significantly improved on the prognosis of IUA with large doses of estrogen without increasing drug side effects.

关 键 词：剂量 戊酸雌二醇 宫腔粘连 临床效果 

分 类 号：R714.62[医药卫生—妇产科学]