雌孕激素序贯疗法辅助宫腔粘连分离术治疗宫腔粘连的效果观察  

Effect of sequential estrogen progesterone therapy assisted transcervical resection of adhesion on intrauterine adhesions

作　　者：路平 郭玉琪[2] 田捧[3] Lu Ping;Guo Yuqi;Tian Peng(Department of Gynaecology and Obstetrics,Henan Provincial No.3 People’s Hospital,Zhengzhou 450000,China;Department of Gynecology,Henan Province People’s Hospital,Zhengzhou 450000,China;Color Doppler Ultrasound Room,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]河南省直第三人民医院妇产科,郑州450000 [2]河南省人民医院妇科,郑州450000 [3]郑州大学第三附属医院彩超科,450000

出　　处：《中国实用医刊》2021年第23期67-70,共4页Chinese Journal of Practical Medicine

摘　　要：目的分析雌孕激素序贯疗法辅助宫腔粘连分离术(TCRA)治疗宫腔粘连(IUA)的效果。方法抽取2019年4月至2020年4月河南省直第三人民医院收治的IUA患者96例,按随机数字表法分为序贯组与TCRA组,每组48例。TCRA组采用TCRA,序贯组加用雌孕激素序贯疗法辅助治疗。比较两组疗效,比较两组治疗前后月经情况、子宫体情况、子宫内膜穿支血流分级及性激素水平,比较两组的预后情况。结果序贯组总有效率(89.58%,43/48)高于TCRA组(29.17%,34/48),P<0.05。治疗后,序贯组月经情况优于TCRA组(P<0.05),子宫体积及内膜厚度均大于对照组(P均<0.05)。治疗后,序贯组子宫内膜穿支血流分级优于TCRA组(P<0.05);雌二醇、孕酮水平高于TCRA组(P<0.05)。序贯组再粘连率(2.22%,1/45)低于TCRA组(18.18%,8/44),妊娠率(91.11%,41/45)高于TCRA组(70.45%,31/44),P<0.05。结论雌孕激素序贯疗法辅助TCRA治疗IUA,可调节性激素水平,改善月经、子宫体情况和子宫内膜穿支血流,提高预后,临床效果确切。Objective To analyze the efficacy of sequential estrogen progesterone therapy assisted transcervical resection of adhesion(TCRA)in the treatment of intrauterine adhesion(IUA).Methods A total of 96 IUA patients treated in Henan Provincial No.3 People’s Hospital from April 2019 to April 2020 were selected,and they were divided into sequential group and TCRA group by random number table method,with 48 cases in each group.The TCRA group was treated by TCRA,and the sequential group was treated by TCRA and sequential estrogen progesterone therapy.The curative effect were compared between the two groups.Menstrual status,uterine body condition,endometrial perforation blood flow grade,sex hormone level before and after treatment were compared between the two groups.And the prognosis of the two groups were compared.Results The total effective rate in sequential group was 89.58%(43/48),higher than the 29.17%(34/48)in TCRA group(P<0.05).The menstrual status of sequential group was better than that of TCRA group after treatment(P<0.05).Compared with TCRA group,the sequential group had larger uterine volume and thicker intima thickness after treatment(P<0.05).After treatment,endometrial perforation blood flow grade in sequential group was better than that in TCRA group(P<0.05),and the levels of estradiol and progesterone were higher than those in TCRA group(P<0.05).The re-adhesion rate in sequential group(2.22%,1/45)was lower than than in TCRA group(18.18%,8/44),and pregnancy rate(91.11%,41/45)was higher than that in TCRA group(70.45%,31/44),P<0.05.Conclusions The sequential estrogen progesterone therapy with TCRA in the treatment of IUA can regulate the level of sex hormones,improve menstruation,uterine body condition and endometrial perforating blood flow,and improve the prognosis,with definite clinical effect.

关 键 词：宫腔粘连 宫腔粘连分离术 雌孕激素序贯疗法 性激素水平 子宫体情况 

分 类 号：R713.4[医药卫生—妇产科学]