不同方式预防宫腔镜下宫腔粘连分离术后宫腔再粘连的效果分析  

Effect analysis on different ways on prevention against postoperative intrauterine adhesion againafter hysteroscopic trans-cervical resection of adhesions

作　　者：李娜[1] 陈贵芹 史素娥[1] 李辉[1] 董黎[1] 王素芳[1] 金靖[1] 王朕华[1] 王悦[1] Li Na;Chen Guiqin;Shi Su ＇ e;Li Hui;Dong Li;Wang Sufang;Jin Jing;Wang Zhenhua;Wang Yue(Department of Gynaecology, Henan Provincial People＇s Hospital, Zhengzhou 450003, Chin)

机构地区：[1]河南省人民医院妇科,郑州450003

出　　处：《中国实用医刊》2018年第7期17-20,共4页Chinese Journal of Practical Medicine

基　　金：河南省医学科技攻关计划项目（201702229）

摘　　要：目的探讨不同方式预防宫腔镜下宫腔粘连分离术（TCRA）后宫腔再粘连的效果。方法选取中、重度宫腔粘连患者60例，按TCRA术后预防粘连再复发方法分为对照组与研究组，每组30例。对照组TCRA术后宫内放置金属“0”环，同时服用戊酸雌二醇（E2V）和安宫黄体酮片（MPA）治疗；研究组宫内放置表面包裹Inter-teed的支撑球囊，同时服用E2V和MPA治疗，方法同对照组。比较两组治疗前及术后第1、3、6个月临床症状和宫腔镜结果。结果术后第1个月，研究组临床总治愈率（20．00％）、总有效率（73．33％）高于对照组（16．67％、56．67％），差异有统计学意义（P〈0．05）；术后第3个月，研究组临床总治愈率（46．67％）、总有效率（80．00％）高于对照组（33．33％、63．33％），差异有统计学意义（P〈0．05）；术后第6个月，研究组总有效率（80．00％）高于对照组（53．33％），差异有统计学意义（P〈0．05）。结论对于中、重度宫腔粘连患者，宫腔镜下宫腔粘连分离术后，宫腔内放置表面包绕Interceed的支撑球囊较宫腔内放置宫内节育器的治疗效果更显著，预后更好。再次行TCRA对于临床治疗好转的患者可提高治愈率，但对临床治疗无效的患者无受益。Objective To investigate the effects of different ways of prevention against intrauter- ine adhesions again after hysteroscopie trans-cervial resection of adhesions （TCRA）. Methods 60 pa- tients with moderate or severe intrauterine adhesions were selected as the research objects. According to the prevention of adhesion recurrence again after TCRA, they were divided into control group and re- search group, 30 cases in each group. In control group, the metal O ring was placed in uterine after TCRA, while estradiol valerate （E2V） and medroxyprogesterone acetate tablets （MPA） were adminis- tered at the same time. In the study group, the supporting balloon filled with Interceed was placed in theuterus, while E2V and MPA treatment were used ~n the study group. The clinical symptoms and the re- sults of hysteroscopy were compared between the two groups before and after the first, third, sixth months of operation. Results At the first months after operation, the total cure rate （20. 00% ） and total effec- tive rate （73.33%） of the study group were higher than those of the control group （16. 67%, 56. 67% ）, the difference was statistically significant （P 〈0. 05 ）. At the third month after operation, the total cure rate （46. 67% ） and total effective rate （80%） in the study group were higher than those in the control group （33.33%, 63.33% ）, the difference was statistically significant （P 〈 0. 05 ）. At the sixth month after the operation, the total effective rate of clinical treatment in the study group （80. 00% ） was higher than that of the control group （53.33%）, and the difference was statistically significant （P 〈 0. 05 ）. Conclusions For moderate and severe intrauterine adhesions, place balloon coated by the Inter- ceed in uterine cavity, compared with intrauterine IUD, has more significant effect and better prognosis. Implement TCRA again can improve the cure rate for patients with improved clinical treatment, but there is no benefit for patients who have

关 键 词：宫腔镜下 宫腔粘连分离术 宫腔粘连 

分 类 号：R713.4[医药卫生—妇产科学]