中重度宫腔粘连分离术后两种辅助治疗方法的效果分析  

Effect analysis of two kinds of methods for the treatment of severe intrauterine adhesions after adhesion separation

作　　者：黄建邕[1] 李廉[1] 莫坚[1] 黄英梅[1] 

机构地区：[1]广西医科大学附属南宁市第一人民医院妇科,广西南宁530022

出　　处：《吉林医学》2016年第2期278-280,共3页Jilin Medical Journal

基　　金：南宁市科学研究与技术开发计划项目[项目编号:20133178]

摘　　要：目的：探讨中重度宫腔粘连分离术后联合应用球囊、重复宫腔镜检查及人工周期的方法预防宫腔再粘连的疗效。方法：113例中重度宫腔粘连患者行宫腔镜宫腔粘连分离术后,随机分为两组,观察组术后宫腔放置注水球囊Foley导尿管6-7 d,并予戊酸雌二醇/黄体酮人工周期3个周期,术后重复宫腔镜检查、分离粘连,直至宫腔形态正常;对照组术后放置宫内节育器及人工周期3个周期;术后3、6个月评估宫腔粘连的治疗效果;术后6个月随访月经恢复情况,1年随访受孕情况。结果：观察组和对照组术后3个月宫腔再粘连率分别为30.36%和56.14%,差异有统计学意义（P〈0.05）,6个月后分别为33.93%和61.40%,差异有统计学意义（P〈0.05）,月经好转率分别为76.79%和50.88%,差异有统计学意义（P〈0.05）;1年后妊娠率分别为13.79%和10.71%（P〉0.05）。结论：联合应用球囊、重复宫腔镜检查及人工周期是一种可有效预防中重度宫腔粘连分离术后宫腔再粘连的辅助治疗方法。Objective To investigate the clinical efficacy of severe intrauterine adhesions with Fory balloon urinary catheter、repeat hysteroscopy and artificial cycle treatment. Method 113 patiens of severe intrauterine adhesion underwent transcervical resection of adhesions were randomly divided into 2 groups,the experimental group were given Foly balloon urinary cathete in the uterine 6 - 7 days and three artificial cycle by estradiol valerat and progesterone. Repeated hysteroscopy and separation of adhesions to restore normal uterine shape. The control group given contracetive rine and artificial cycle therapy. Assessment of the therapeutic effect of intrauterine adhesions by hyderoscopic after 3 、6 months,follow- up recovery period and pregnancy situation after 6 months、1 year. Results The rates of intrauterine adhesion of observation group and control group were 30. 36% and56. 14%（ P〈0. 05） after 3 months,respectively,that were 33. 93% and 61. 40%（ P〈0. 05） after 6 months,respectively; The menstrual improvement rate was 76. 79% and 50. 88%（ P〈0. 05）,respectively,the pregnancy rate was 13. 79% and 10. 71%（ P〉0. 05） after 1 year,respectively. Conclusion Fory balloon urinary cathete with repeat hysteroscopy and artificial cycle can effective prevention of severe intrauterine adhesions after transcervical resection of adhesions.

关 键 词：宫腔粘连 宫腔粘连分离术 重复宫腔镜检查 FOLEY尿管 

分 类 号：R713.4[医药卫生—妇产科学]