玻璃酸钠凝胶预防中度宫腔黏连复发的疗效分析  

Efficacy analysis of sodium hyaluronate gel for preventing recurrence of moderate intrauterine adhesion

作　　者：朱金虎[1] 洪小山[1] 周燕[2] Zhu Jinhu;Hong Xiaoshan;Zhou Yan(Department of Gynecology,Guangdong Maternal and Child Health Hospital,Guangzhou 511400,Guangdong Province,China;;Medical Examination Center,Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 510260,Guangdong Province,China)

机构地区：[1]广东省妇幼保健院妇科,广州511400 [2]广州医科大学附属第二医院体检中心,510260

出　　处：《中华妇幼临床医学杂志（电子版）》2018年第1期104-108,共5页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：广东省卫生计生委资助项目(20133086)~~

摘　　要：目的探讨玻璃酸钠凝胶预防中度宫腔黏连(IUA)复发的临床疗效。方法选择2013年1月至2014年1月,于广东省妇幼保健院妇科接受宫腔镜下宫腔黏连分离术(TCRA)治疗的72例中度IUA患者为研究对象。根据患者于TCRA治疗后接受的预防IUA复发治疗措施的不同,将其分为研究组(n=32),接受宫腔涂抹玻璃酸钠凝胶、放置宫内节育器(IUD)及口服戊酸雌二醇、地屈孕酮预防IUA复发治疗;对照组(n=40),接受宫腔放置IUD及口服戊酸雌二醇、地屈孕酮预防IUA复发治疗。对2组患者,均于TCRA治疗后第3个月时,观察其月经恢复情况,并进行宫腔镜复查,评估2组患者所采取措施,对于预防IUA复发治疗的有效率;于TCRA治疗后第6个月时,观察2组患者妊娠情况。采用χ~2检验,比较2组患者于TRCA治疗后所采取措施,对于预防IUA复发治疗的有效率,以及受试者临床妊娠率。本研究遵循的程序符合广东省妇幼保健院人体试验委员会所制定的伦理学标准,得到该委员会批准,并征得受试者知情同意,与之签署临床研究知情同意书。结果 (1)2组患者的年龄、接受人工终止妊娠术次数等一般临床资料比较,差异均无统计学意义(P>0.05)。(2)研究组患者于TCRA治疗后所采取措施,对于预防IUA复发治疗的有效率为71.9%(23/32),显著高于对照组的45.0%(18/40),2组比较,差异有统计学意义(χ~2=5.237,P=0.022)。研究组患者于TCRA治疗后第6个月时的临床妊娠率为34.4%(11/32),对照组为15.0%(6/40),2组比较,差异无统计学意义(χ~2=3.700,P=0.054)。结论中度IUA患者于TCRA治疗后,采用宫腔涂抹玻璃酸钠凝胶、放置IUD及口服雌激素治疗方案,可促进月经恢复、改善宫腔形态,有效预防IUA复发。由于本研究纳入的样本量相对较小,该方法是否值得临床推广用于中度IUA患者于TCRA治疗后预防IUA复发治疗,仍然有待于大样本、多中心的随机对照研究进一步研究、证实。To explore the clinical effects of sodium hyaluronate gel for preventing recurrence of moderate intrauterine adhesion(IUA).Methods From January 2013 to January 2014,a total of 72 patients with moderate IUA who underwent transcervical resection of adhesion(TCRA)by hysteroscopy in Department of Gynecology,Guangdong Maternal and Child Health Hospital were selected as research subjects.According to the prevention methods of IUA recurrence after TCRA,they were divided into study group(n=32)and control group(n=40).Patients in study group were given sodium hyaluronate gel in uterine cavity,placement of intrauterine device(IUD)and oral estradiol valerate and dydrogesterone after TCRA.Patients in control group were given placement of IUD and oral estradiol valerate and dydrogesterone after TCRA.Three months after TCRA treatment,the menstruation recoveries of two groups were observed,and re-examinations of hysteroscopy were performed on all patients in two groups to assess the effective rate of measures taken after TCRA treatment for preventing recurrence of IUA.Six months after TCRA treatment,clinical pregnancies of two groups were observed.The effective rates of measures taken after TCRA treatment for preventing recurrence of IUA and clinical pregnancy of two groups were compared by chi-square test.This study was approved by the Ethics Committee of Human Beings in Guangdong Maternal and Child Health Hospital and every subject signed informed consent of clinical research.Results①There were no statistical differences between two groups in the aspects of age,times of artificial termination and so on(P>0.05).②The effective rate of measures taken after TCRA treatment for preventing recurrence of IUA in study group was 71.9%(23/32),which was statistically higher than that of control group 15.0%(6/40),and the difference was statistically significant(χ2=5.237,P=0.022).After 6-month of treatment by TCRA,the clinical pregnancy rate in study group was 34.4%(11/32),and 15.0%(6/40)in control group,but there was no statistical di

关 键 词：玻璃酸钠 宫腔黏连 治疗效果 复发 宫腔镜下宫腔黏连分离术 妇女 

分 类 号：R713.4[医药卫生—妇产科学]