放置防粘连膜或注水球囊预防重度宫腔粘连术后复发疗效研究  

Efficacy of absorbable adhesion barrier or Foley balloon in the prevention of relapse of severe intrauterine adhesions

作　　者：姚秀华[1] 刘剀[1] 都红蕾[1] 黄卓敏[1] 黄山鹰[1] 王耀楷[1] 

机构地区：[1]南方医科大学附属深圳妇幼保健院妇科,广东深圳518000

出　　处：《中国实用妇科与产科杂志》2016年第6期541-544,共4页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：深圳市卫生计生系统科研项目(201402064)

摘　　要：目的 探讨放置防粘连膜或注水球囊预防重度宫腔粘连术后复发的疗效。方法 回顾性分析2009年6月至2014年6月南方医科大学附属深圳妇幼保健院收治的80例重度宫腔粘连患者,所有病人均行宫腔镜下宫腔粘连分离术（TCRA）,术后服用戊酸雌二醇3个月。根据术后处理方法分成3组。A组（34例）：术后放置宫内节育器（IUD）;B组（23例）：术后放置Foley球囊导尿管,同时注入透明质酸钠凝胶,3 d后再次注入透明质酸钠凝胶并取出球囊,宫内放置IUD。在术后第1、2个月月经干净后3-5 d内,再次取环并放置球囊导尿管,3 d后取出重新放置IUD;C组（23例）：术后放置氧化再生防粘连膜（interceed）＋IUD。术后3个月,均行二次宫腔镜探查,评估治疗效果。结果 B组治疗总有效率87%（20/23）,C组治疗总有效率96%（22/23）,均明显高于A组（62%,21/34）,差异有统计学意义（P〈0.05）;C组的总有效率高于B组,但两组比较差异无统计学意义（P〉0.05）。结论 TCRA术后放置球囊导尿管或防粘连膜均可有效预防重度宫腔粘连术后复发。Objective To explore the clinical effect of Foley balloon and absorbable adhesion barrier（ Interceed ） on the prevention of the relapse of intrauteIine adhesions after hysteroscopic operation among patients with severe intrauterine adhesions. Methods Eighty cases of severe intrauterine adhesions in the Affiliated Shenzhen Maternity and Child Heahhcare Hospital of the South Medical University were selected as study subjects, and they were divided into three groups.All the patients were treated with estradiol valerate for 3 months after transcervical resection of adhesions（TCRA）. Patients of group A （34 cases） were treated with installed intrauterine device（IUD）. Patients of group B（23 cases） were treated with Foley balloon and hyaluronic acid , and after 3 days, Foley balloon was taken out and hyaluronic acid was given again, then IUD installed .In the 1st and 2nd month 3 - 5 days after menstIuation, take out IUD, install Foley balloon , and after 3 days, take out Foley balloon, then install IUD .Group C （23 cases） were treated with Interceed and IUD. After 3 months, hysteroscopy was performed again to evaluate the treatment effect.Results The total effective rate of group B was 87%, and reached 96% in Group C, which was remarkably higher than that of group A（62%）, the difference being statistically significant （P〈 0.05）. Although, the total effective rate of group C was higher than that of group B, there was no significant difference between them （P〉0.05）. Conclusion The Interceed anti-adhesion membranes and Foley balloon are all good for preventing intrauterine adhesions after TCRA.

关 键 词：宫腔粘连 球囊 防粘连膜 宫腔镜下宫腔粘连分离术 

分 类 号：R711.74[医药卫生—妇产科学]