两种不同病因所致宫腔粘连的临床研究  

Clinical study of intrauterine adhesions caused by two different diseases

作　　者：王鹏 李世杰[1] 林霞[1] WANG Peng;LI Shijie;LIN Xia(Department of Maternal Health,Pok Oi Hospital,Zhongshan,Zhongshan 528400,China)

机构地区：[1]中山市博爱医院孕产保健部,广东中山528400

出　　处：《新疆医学》2020年第10期1063-1065,共3页Xinjiang Medical Journal

基　　金：中山市科技计划(项目编号:2018A020386)。

摘　　要：目的研究两种不同病因所致宫腔粘连(IUA),探讨疗效及预后。方法将本院生殖内分泌科2018年1月至2019年5月因稽留流产清宫后宫腔粘连(IUA)患者85例纳入A组,并将同期因人工流产后IUA患者85例纳入B组。均行宫腔镜下宫腔粘连分离术(TCRA),术后轻度粘连采用雌孕激素治疗,中重度粘连采用雌孕激素+COOK球囊治疗。对比不同病因中不同程度IUA的治疗效果及不同病因IUA治疗后预后及妊娠结局。结果行TCRA后,两组宫腔粘连程度对比,差异无统计学意义(P>0.05);两组轻度IUA、中重度IUA治疗后效果对比,差异无统计学意义(P>0.05);A组与B组复发率均较低,妊娠率均达到50%以上,组间对比,差异无统计学意义(P>0.05)。结论不同病因引起的宫腔粘连,术后根据粘连程度采用药物治疗或药物联合COOK球囊治疗,效果均较好,可减低宫腔粘连、改善宫颈与月经情况,术后复发率低,从而提高妊娠率。Objective To study the intrauterine adhesions(IUA)caused by two different diseases,and to explore the efficacy and prognosis.Methods From January 2018 to May 2019,85 cases of IUA patients in our hospital after the abortion due to miscarriage were selected as the research subjects(group A),and 85 cases of IUA patients after induced abortion during the same period were selected as group B.All patients underwent hysteroscopic hysterectomy(TCRA).Mild adhesions were treated with estrogen and progestin,and moderate to severe adhesions were treated with estrogen and COOK balloon.The therapeutic effects of IUA with different degrees in different etiology and the prognosis and pregnancy outcome of IUA with different etiology were compared.Results After TCRA,there was no significant difference in the degree of intrauterine adhesions between the two groups(P>0.05);There was no significant difference in the curative effects between mild IUA and moderate to severe IUA between the two groups(P>0.05);The recurrence rate was lower in group B than that in group B,and the pregnancy rate reached more than 50%.There was no significant difference between the groups(P>0.05).Conclusions Drug therapy or a drug combined with COOK balloon treatment based on the degree of adhesion caused by different causes of intrauterine adhesions is effective.It can reduce intrauterine adhesions,improve cervical and menstrual conditions,and reduce the postoperative recurrence rate,thereby increase the pregnancy rate.

关 键 词：宫腔粘连 稽留流产 人工流产 预后 妊娠结局 

分 类 号：R711[医药卫生—妇产科学]