中重度宫腔粘连术后三种预防再粘连方案的临床疗效观察  

Observation on the clinical efficacy of three methods for preventing re-adhesion after moderate to severe intrauterine adhesions

作　　者：姜霓 JIANG Ni(Department of Gynecology,Shenzhen Far East Obstetrics and Gynecology Hospital,Shenzhen 518000,China)

机构地区：[1]深圳远东妇产医院妇科病区,518000

出　　处：《中国实用医药》2021年第10期27-30,共4页China Practical Medicine

摘　　要：目的探究中重度宫腔粘连术后采用三种预防再粘连方案的临床效果。方法 90例中重度宫腔粘连患者,随机分为A组、B组、C组,每组30例。A组采用宫腔镜下宫腔粘连分离术联合防粘连膜包绕宫内节育器宫腔放置方案, B组采用宫腔镜下宫腔粘连分离术联合宫腔球囊扩张治疗7 d取出方案, C组采取宫腔镜下宫腔粘连分离术联合宫腔球囊治疗30 d取出方案,三组术后均联合人工周期治疗。比较三组初次粘连评分与初次手术前月经评分、治疗效果、术后感染情况。结果 A组中度粘连程度患者初次粘连评分为(13.78±2.82)分、初次手术前月经评分为(1.81±0.40)分,重度粘连程度患者分别为(15.38±4.71)、(2.58±0.97)分;B组中度粘连程度患者初次粘连评分为(14.19±2.06)分、初次手术前月经评分为(1.76±0.44)分,重度粘连程度患者分别为(16.19±5.00)、(2.34±0.81)分;C组中度粘连程度患者初次粘连评分为(15.05±2.75)分、初次手术前月经评分为(1.77±0.43)分,重度粘连程度患者分别为(16.45±6.02)、(2.61±0.96)分。三组相同粘连程度患者初次粘连评分、初次手术前月经评分比较,差异均无统计学意义(P>0.05)。术后, A组总有效率为73.33%, B组总有效率70.00%, C组总有效率为93.33%, C组总有效率高于A组及B组,差异有统计学意义(P<0.05)。C组术后感染率为53.33%,高于A组与B组的13.33%、16.67%,差异有统计学意义(P<0.05)。但患者大部分无明显临床症状,偶有发热及下腹痛,多数为宫颈细菌培养阳性,感染在可控范围内。结论患者行宫腔粘连分离术后延长放置宫腔球囊时间,能够促进宫腔重塑以及内膜修复,可显著提高疗效,改善月经,临床优势明显,术后感染几率随之增加,但感染多为实验室检查异常,临床症状不明显,感染在可控范围内。Objective To investigate the clinical effect of three methods for preventing re-adhesion after moderate to severe intrauterine adhesions. Methods A total of 90 patients with re-adhesion after moderate to severe intrauterine adhesions were randomly divided into group A, group B and group C, with 30 cases in each group. Group A received hysteroscopic intrauterine adhesions separation combined with anti adhesion membrane wrapping intrauterine device placement, group B received hysteroscopic intrauterine adhesions separation combined with intrauterine balloon dilatation for 7 d, and group C was treated with hysteroscopic intrauterine adhesions separation combined with intrauterine balloon dilatation for 30 d. All three groups were combined with artificial cycle treatment after operation. The initial adhesion scores, menstrual score before the first operation, therapeutic effect and postoperative infection of the three groups were compared. Results In group A, the initial adhesion score of the patients with moderate adhesion was(13.78±2.82) points, the menstrual score before the first operation was(1.81±0.40) points, and those scores of the patients with severe adhesion were(15.38±4.71) and(2.58±0.97) points, respectively;in group B, the initial adhesion score of the patients with moderate adhesion was(14.19±2.06) points, the menstrual score before the first operation was(1.76±0.44) points, and those scores of the patients with severe adhesion were(16.19±5.00) and(2.34±0.81) points, respectively;in group C, the initial adhesion score of patients with moderate adhesion was(15.05±2.75) points, the menstrual score before the first operation was(1.77±0.43) points, and those scores of the patients with severe adhesion were(16.45±6.02) and(2.61±0.96) points. There was no statistically significant difference in initial adhesion score and menstrual score before the first operation among the three groups of patients with the same degree of adhesion(P>0.05). After operation, the total effective rate of group A was 7

关 键 词：中重度宫腔粘连术 宫腔再粘连 月经评分 宫腔球囊 

分 类 号：R713.4[医药卫生—妇产科学]