不同途径高血浓度雌二醇联合包裹防粘连膜金属环对预防宫腔再粘连作用研究  

Effect of High Blood Concentration of Estradiol Combined with Absorbable Adhesion Barrier in Preventing Re-adhesion of Patients with Intrauterine Adhesions

作　　者：李秋平 张昀 罗小平 熊芳 LI Qiuping;ZHANG Yuna;LUO Xiaoping(Assisted Reproductive Center;Department of Gynecology,The Affiliated Wuxi Maternity and Child Health Hospital of Nanjing Medical University,Wuxi Jiangsu 214000,China)

机构地区：[1]南京医科大学附属无锡妇幼保健院生殖中心,江苏无锡214000 [2]南京医科大学附属无锡妇幼保健院妇科,江苏无锡214000

出　　处：《实用妇产科杂志》2019年第10期764-768,共5页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:观察阴道用17-β雌二醇联合包裹防粘连膜的金属圆环及口服戊酸雌二醇联合包裹防粘连膜的金属圆环对宫腔粘连分离术(TRCA)后结局的影响。方法:选择2015年4月至2018年4月在我院住院治疗的宫腔粘连患者60例进行TRCA后随机分为A、B组,分别采取包裹防粘连膜的金属圆环+阴道用17-β雌二醇2 mg(A组)、包裹防粘连膜的金属圆环+口服戊酸雌二醇3 mg(B组)2种方法预防宫腔粘连,观察两组的副反应及比较疗效。结果:两组患者均无明显副反应。术后血雌二醇浓度A组明显高于B组,差异有统计学意义(P<0.05)。两组患者术后月经情况均较术前改善,差异有统计学意义(P<0.05),A组改善率高于B组。两组患者术后预后评分、评分改善情况比较,差异均有统计学意义(P<0.05)。两组有效率差异有统计学意义(P<0.05),两组总有效率差异无统计学意义(P>0.05),显效率两组差异有统计学意义(P<0.05),A组高于B组。两组复发率无统计学差异(P<0.05)。结论:阴道用17-β雌二醇联合防粘连膜包裹环对预防宫腔粘连术后复发的疗效与口服戊酸雌二醇联合防粘连膜包裹环相当,但在改善宫腔形态及月经情况方面,前者效果优于后者。Objective:To observe the effect of vaginal 17-beta estradiol and oral Estradiol valerate combined with anti-adhesion barrier in preventing re-adhesion of patients with intrauterine adhesions( IUA) after transcervical resection of adhesions( TRCA). Methods:A total of 60 patients hospitalized in our hospital from April 2015 to April 2018 diagnosed as IUA were enrolled in this study. They were randomly divided into 2 groups. Group A was Intrauterine device( IUD) encapsulated by absorbable adhesion barrier( polylactic acid membrane) and vaginal17-beta estradiol 2 mg,group B was IUD encapsulated by absorbable adhesion barrier and oral estradiol valerate( E2 V) 3 mg. Side effects and therapeutic effects were observed. Results:There was no obvious side effects in both groups. The blood concentration of estradiol in group A was significantly higher than that in group B( P <0. 05). In aspect of menstrual improvements,postoperative menstrual models were both better than that before operation,the differences were significant( P < 0. 05). Comparing menstrual improvement rates in two groups,group A was significantly higher than that in group B,difference was statistically significant( P < 0. 05). A comparison of postoperative prognosis score,improve score( preoperative-postoperative) in two groups,the differences were significant( P < 0. 05). There difference of effective rate was statistically significant in two groups( P < 0. 05).There was no significant difference in total effective rate( P < 0. 05). But the efficiency rate was different in two groups,in which,group A was greater than that in group B,the difference was statistically significant( P < 0. 05),there was no significant difference in the recurrence rate( P > 0. 05). Conclusions:Vaginal 17-beta estradiol combined with IUD encapsulated by absorbable adhesion barrier is as fine as IUD encapsulated by absorbable adhesion barrier and oral estradiol valerate in preventing re-adhesion after TRCA,but in the aspect of improving the uterine cavity morphology and menstrual

关 键 词：宫腔粘连 防粘连膜 17-Β雌二醇 阴道用药 

分 类 号：R711.3[医药卫生—妇产科学]