中重度宫腔粘连患者术后辅以雌孕激素周期治疗和GnRH-a治疗的效果观察  

Curative efficacy of the estrogen and progesterone therapy and GnRH-a therapy on patients with moderate or severe intrauterine adhesion

作　　者：李鲁宏[1] 蔡佩雅 张培茹[1] 

机构地区：[1]福建医科大学附属第二医院妇产科,福建泉州362000

出　　处：《河北医科大学学报》2017年第9期1049-1053,共5页Journal of Hebei Medical University

摘　　要：目的通过对中重度宫腔粘连患者临床预后资料的观察,比较中重度宫腔粘连宫腔镜电切术后辅以雌孕激素周期治疗和促性腺激素释放激素激动剂(gonadotrophin-releasing hormone agonist,GnRH-a)治疗预防再粘连的临床效果。方法选择经临床确诊的中重度宫腔粘连患者138例,其中中度宫腔粘连78例,重度宫腔粘连60例,随机分为实验组和对照组各69例,对照组于宫腔镜电切术后给予人工周期治疗,实验组给予联合GnRH-a治疗,比较2组月经周期恢复及术后再粘连情况。结果 2组术后宫腔容积差异无统计学意义(P>0.05);实验组月经好转率优于对照组(P<0.05);实验组宫腔再粘连率低于对照组(P<0.05);术后3个月后,实验组和对照组VAS评分及CA125水平均显著下降(P<0.05),但实验组结果均优于对照组(P<0.05);实验组术后妊娠成功率高于对照组(P<0.05)。结论宫腔粘连患者术后联合GnRH-a治疗较雌孕激素人工周期治疗的效果更明显。Objective To compare the re-adhesion prevention effect of artificial cyclic estrogen-progesterone and gonadotrophin-releasing hormone agonist（GnRH）treatment on patients after hysteroscopic operation for moderate to severe intrauterine adhesions,and clinical outcome data from our hospital were analyzed statistically.Methods One hundred and thirtyeight patients including 78 cases of clinically diagnosed as moderate and 60 cases of severe intrauterine adhesions were divided into the experimental group（n=69 cases） and the control group（n =69 cases）randomly.The control group was treated with artificial cycle after hysteroscopy,the experimental group was treated with combined GnRH-a.The clinical effects of two groups of patients with menstrual cycle recovery and postoperative recurrence were compared.Results There was no significant difference between the 2 groups in volume of uterine cavity（P〈0.05）.The improvement rate of menstruation in the experimental group was better than that of the control group（P〈0.05）;the intrauterine re-adhesion rate was lower than that of control group（P〈0.05）.After 3 months of operation,the VAS score and CA125 level of the experimental group and the control group were significantly decreased（P〈0.05）,but the results in the experimental group was better than the control group（P〈0.05）.The pregnancy success rate in the experimental group was higher than the control group（P〈0.05）.ConclusionCombined with GnRH-a treatment,the effect of artificial cycle therapy is more obvious in female patients with intrauterine adhesions.

关 键 词：宫腔粘连 雌激素类 孕激素类 妊娠结局 

分 类 号：R711.32[医药卫生—妇产科学]