不同程度宫腔粘连行宫腔镜下粘连分解术联合雌孕激素序贯疗法对妊娠率的影响  

Comparison of the clinical efficacy and pregnancy rate of hysteroscopy combined with artificial cycle in the treatment of different degree of intrauterine adhesion

作　　者：曾燕 Zeng Yan(Department of Gynaecology and Obstetrics,Chongqing No.7 People's Hospital,Chongqing,400069,China)

机构地区：[1]重庆市第七人民医院妇产科,重庆400069

出　　处：《当代医学》2020年第16期89-91,共3页Contemporary Medicine

摘　　要：目的研究讨论不同程度宫腔粘连行宫腔镜下粘连分解术联合雌孕激素序贯疗法对妊娠率的影响。方法选取本院2014年6月至2016年2月行宫腔镜下粘连分解术的患者58例作为研究对象。所有患者行宫腔镜下粘连分解术,并在术后给予炔雌醇及醋酸甲地孕酮序贯治疗,治疗一段时间后再次用宫腔镜评价宫腔形态。采用美国生殖协会标准(AFS)对宫腔粘连程度进行评分,随访分析宫腔镜下粘连分解术联合雌孕激素序贯疗法对不同程度宫腔粘连妊娠率的影响。结果依据宫腔粘连程度划分,轻度粘连20例,中度粘连23例,重度粘连15例。宫腔粘连程度与治疗效果比较差异有统计学意义(P<0.05)。宫腔镜手术前后各组AFS评分比较差异均具有统计学意义(P<0.05),各组患者AFS值比较差异具有统计学意义(P<0.05)。组间术后复发率比较差异有统计学意义(P=0.024)。组间术后月经恢复情况比较差异无统计学意义(P=0.513)。术后妊娠成功率方面,重度组患者无妊娠成功病例,轻度组和中度组患者的妊娠率比较差异有统计学意义(P=0.045)。结论宫腔镜下粘连分解术联合雌孕激素序贯疗法对不同程度宫腔粘连具有很好的临床效果,可以有效的避免宫腔再次粘连,术后采用雌孕激素序贯疗法的治疗手段可以有效的修复内膜,增加子宫内膜的容受性,达到更好的术后康复效果。Objective The effect of hysteroscopy combined with sequential estrogen and progestin therapy on the pregnancy rate in different degrees of hysteroscopy was discussed.Methods 58 cases taken hysteroscopy from June 2014 to February 2016 in our hospital were selected as study subjects.All of the patients were taken hysteroscopy combined with artificial cycle,evaluated uterine cavity form by hysteroscopy after treatment.Scored the degree of intrauterine adhesion by AFS,compared the clinical efficacy and pregnancy rate of different degree of intrauterine adhesion.Results According to the degree of uterine adhesion,there was 20 slight adhesion cases,23 moderate adhesion cases,15 severe adhesion cases.There was significant difference in the degree of intrauterine adhesions and treatment(P<0.05).In the comparison of AFS score before and after hysteroscopic surgery between preoperative and postoperative showed that the difference was statistically significant(P<0.05),the AFS values of each group were statistically significant difference(P<0.05).In the postoperative recurrence rate,there was significant difference between the two groups(P=0.024).There was no significant difference between the two groups in postoperative recovery(P=0.513).In the success rate of postoperative pregnancy,there was no pregnancy success in severe group,and there was significant difference in the pregnancy rate between mild and moderate patients(P=0.045).Conclusion Hysteroscopy combined with artificial cycle has good clinical effect on different degrees of uterine adhesion,and can effectively avoid uterine re-adhesion,the artificial period can effectively repair the intima after the operation,increase the endometrial receptivity,achieve better effect of postoperative rehabilitation.

关 键 词：宫腔镜治疗 宫腔粘连 雌孕激素序贯疗法 妊娠率 

分 类 号：R713.4[医药卫生—妇产科学]