子宫中隔切除术后预防宫腔粘连的临床探讨  

Preventing intrauterine adhesion after transcervical resection of uterine septum

作　　者：万晓丽[1] 许洪梅[1] 夏秀英[1] 冯志萍 任王静 彭迎春[1] WAN Xiao-li;XU Hong-mei;XIA Xiu-ying;FENG Zhi-ping;REN Wang-jing;PENG Ying-chun(Department of Gynecology,People＇s Hospital of Leshan,Sichuan Leshan 614000,China)

机构地区：[1]乐山市人民医院妇科,四川乐山614000

出　　处：《中国妇幼健康研究》2018年第10期1323-1326,共4页Chinese Journal of Woman and Child Health Research

摘　　要：目的探讨宫腔镜子宫中隔切除术(TCRS)后3种辅助治疗对预防宫腔粘连的疗效。方法选择2009年1月至2017年6月在乐山市人民医院行TCRS的患者89例,分为四组:A组术后不采取任何干预措施;B组术后行雌孕激素周期治疗3个月;C组术后放置宫内节育器(IUD)+雌孕激素周期治疗3个月;D组:术后宫腔内留置球囊5天。TCRS术后1个月、3个月进行宫腔镜复查。结果 A、B、C、D四组术后1个月宫腔粘连的发生率分别为15.00%(3/20)、16.00%(4/25)、14.29%(3/21)、15.79%(3/19),组间比较差异无统计学意义(χ2=0.031,P>0.05);术后3个月宫腔粘连的发生率分别为6.25%(1/16)、0(0/24)、4.35%(1/23)、0(0/17),组间比较差异无统计学意义(P>0.05)。结论 TCRS患者术后给予雌孕激素周期治疗、IUD+雌孕激素周期治疗或宫腔内留置球囊治疗在预防宫腔粘连方面无明显疗效,术后可不必将其作为常规辅助治疗手段。Objective To investigate the clinical efficacy of three kinds of treatment in preventing intrauterine adhesion after transcervical resection of uterine septum（TCRS）.Methods Eighty-nine patients who underwent TCRS in People＇s Hospital of Leshan were allocated into four groups,group A not receiving any postoperative intervention treatment,group B receiving postoperative estrogen and progesterone therapy for 3 months,group C putting intrauterine contraceptive device（IUD）combined with estrogen and progesterone therapy for 3 months,and group D putting balloon for 5 days.All subjects underwent hysteroscopy1 month and 3 months after surgery.Results The intrauterine adhesion rates of four groups 1 month after surgery were 15.00%（3/20）,16.00%（4/25）,14.29%（3/21）and 15.79%（3/19）,respectively,and the differences were not significant（χ^2=0.031,P〉0.05）.At the third month they were 6.25%（1/16）,0.00%（0/24）,4.35%（1/23）and 0.00%（0/17）,respectively,and there was no significant differences among these four groups（P〉0.05）.Conclusion Postoperative estrogen and progesterone therapy,IUD combining estrogen and progesterone therapy,or intrauterine balloon has no remarkable significance in reducing the incidence of postoperative intrauterine adhesion.Accordingly these methods are not necessary as conventional adjuvant therapy after TCRS.

关 键 词：子宫中隔 宫腔镜子宫中隔切除术 宫腔粘连 辅助治疗 

分 类 号：R711.7[医药卫生—妇产科学]