球囊支架不同放置时间对宫腔粘连分离术后复发的预防价值及安全性比较  

Comparison of the value and safety of COOK balloon stents placed in patients with intrauterine adhesion for different duration to prevent recurrence

作　　者：陈丹丹[1] 石丽萍[1] 卢健翔[1] 孙挺[1] 董瑞 周明[1] CHEN Dandan;SHI Liping;LU Jianxiang;SUN Ting;DONG Rui;ZHOU Ming(Department of Obstetrics and Gynecology,The People's Hospital of Luohu District,Shenzhen,Guangdong 518001,China)

机构地区：[1]深圳市罗湖区人民医院妇产科,广东深圳518001

出　　处：《安徽医药》2021年第2期369-372,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的对比COOK球囊支架不同放置时间对宫腔粘连(IUA)病人宫腔粘连分离术(TCRA)术后复发的预防价值及安全性。方法选取2016年8月至2018年3月深圳市罗湖区人民医院收治的IUA病人236例,均于宫腔镜下行TCRA治疗。按照术后COOK球囊支架放置时间的不同分成A组(术后COOK球囊支架放置时间为5 d)66例、B组(术后COOK球囊支架放置时间为30 d)101例、C组(术后COOK球囊支架放置时间为60 d)69例。分别比较三组月经改善情况,并发症发生情况,复发情况以及手术前后AFS评分情况。结果A、B、C三组月经改善率分别为45.45%、87.13%、92.75%,B、C组明显高于A组(均P<0.05)。三组生殖道感染、球囊支架脱出或下移、子宫穿孔、球囊支架嵌顿发生率比较,均差异无统计学意义(均P>0.05)。A、B、C三组术后复发率分别为31.82%、9.90%、8.70%,B、C组明显低于A组(均P<0.05)。A、B、C三组术后AFS评分均低于术前,且B、C组术后AFS评分均低于A组(均P<0.05)。结论IUA病人术后放置COOK球囊支架30 d、60 d可发挥显著的预防术后复发效果,且安全性较好,有利于提高病人的月经改善率。因此,TCRA术后COOK球囊支架宫腔放置时间选择30 d是可行方案。Objective To compare the preventive value and safety of COOK balloon stents placed for different duration in patients with intrauterine adhesion(IUA)after transcervical resection of adhesion(TCRA).Methods A total of 236 patients with IUA admitted to the People’s Hospital of Luohu District from August 2016 to March 2018 were selected as study subjects.All patients were treated with TCRA.According to the postoperative placement time of COOK balloon stents,the patients were assigned in group A(duration of postoperative COOK balloon stent placement:5 d;n=66),group B(duration of postoperative COOK balloon stent placement:30 d;n=101),and group C(duration of postoperative COOK balloon stent placement:60 d;n=69).Menstrual improvement,complications,recurrence and American Fertility Society(AFS)scores before and after surgery were compared among the three groups.Results The menstrual improvement rates of groups A,B and Cwere 45.45%,87.13%and 92.75%,respectively,which were significantly higher in group B and C than in group A(all P<0.05).There was no significant difference in the incidence of genital tract infection,balloon stent prolapse or descending,uterine perforation,and balloon stent incarceration among groups A,B,and C(all P>0.05).The postoperative recurrence rates of groups A,B and C were 31.82%,9.90%and 8.70%,respectively,which were significantly lower in group B and C than in group A(all P<0.05).Postoperative AFS scores of groups A,B and Cwere all lower than those before surgery,and postoperative AFS scores of group B and C were both lower than that of group A(all P<0.05).Conclusion After IUA surgery,the placement of COOK balloon stents for 30 d and 60 d can significantly prevent postoperative recurrence,and the safety is good,which is conducive to increasing the menstrual improvement rate of patients.Therefore,30 d placement of COOK balloon stents after TCRA is a feasible plan.

关 键 词：子宫疾病 组织粘连 球囊支架 放置时间 术后复发 安全性 

分 类 号：R713.4[医药卫生—妇产科学]