三种不同雌激素治疗方案在结核性宫腔粘连中的应用对比研究  

Comparative study on the application of three different estrogen treatment programs in tuberculous intrauterine adhesions

作　　者：姚玉洁[1] 李晓冬[2] 董晓瑜[1] 温俊霞[1] 刘小辉 YAO Yujie;LI Xiaodong;DONG Xiaoyu;WEN Junxia;LIU Xiaohui(Hebei Chest Hospital,Shijiazhuang,Hebei 050041,China;The Second Hospital of Hebei Medical University,Shijiazhuang,Hebei 050000,China)

机构地区：[1]河北省胸科医院,河北石家庄050041 [2]河北医科大学第二医院,河北石家庄050000

出　　处：《中国优生与遗传杂志》2022年第3期401-406,共6页Chinese Journal of Birth Health & Heredity

基　　金：2018年度医学科学研究重点课题计划(20180681)。

摘　　要：目的 探讨三种不同雌激素治疗方案在结核性宫腔粘连中的应用效果,旨在为结核性宫腔粘连患者的促内膜生长提供新的诊疗思路及给药方法。方法 回顾性分析2018年1月—2021年1月我院结核性宫腔粘连患者135例,根据治疗方案不同分为三组,每组45例,A组口服雌激素治疗,B组阴道用雌激素半片(0.5mg/d)治疗,C组阴道用雌激素1片(1.0 mg/d)治疗,比较三组临床疗效、月经恢复情况及治疗前后宫腔粘连程度、雌激素浓度、子宫内膜厚度,并记录不良反应情况及妊娠率。结果 C组总有效率97.78%,显著高于A组(77.78%)、B组(82.22%)(P<0.05),A组、B组总有效率相比,差异无统计学意义(P>0.05)。三组月经恢复总有效率相比,差异无统计学意义(P>0.05)。治疗6周、12周后C组宫腔粘连程度显著低于A组和B组(P<0.05),且A组、B组相比,差异无统计学意义(P>0.05)。治疗2周、6周及12周后,C组雌激素浓度显著高于A组和B组,且B组显著高于A组(P<0.05)。治疗2周、6周及12周后三组子宫内膜厚度均显著高于治疗前(P<0.05),且三组在同一时期子宫内膜厚度相比,差异无统计学意义(P>0.05)。治疗后1年,A组妊娠率28.89%(13/45);B组妊娠率31.11%(14/45);C组妊娠率40.00%(18/45),三组妊娠率相比,差异无统计学意义(P>0.05)。三组不良反应发生率相比,差异无统计学意义(P>0.05)。结论 阴道大剂量用雌激素能明显改善宫腔粘连患者的子宫内膜厚度,可有效改善患者宫腔粘连和月经情况,并具有一定用药安全性。Objective To provide new diagnosis and treatment ideas and drug delivery methods for patients with tuberculous intrauterine adhesions to promote endometrial growth,application effects of three different estrogen treatments in tuberculous intrauterine adhesions was explored.Methods A retrospective analysis of 135 patients with tuberculous intrauterine adhesions in our hospital from January 2018 to January 2021 were divided into three groups according to the different treatment plans with 45 cases in each group.Group A was treated with oral estrogen,group B was treated with vaginal estrogen half tablet(0.5 mg/d),and group C was treated with vaginal estrogen 1 tablet(1.0 mg/d).The clinical efficacy,menstrual recovery,uterine adhesions before and after treatment,estrogen concentration,and endometrium thickness in the three groups were compared.Adverse reactions and pregnancy rate were recorded.Results The total effective rate of group C was 97.78%,significantly higher than group A(77.78%) and group B(82.22%)(P<0.05),while there was no significant difference in the total effective rate between group A and group B(P>0.05).There was no significant difference in the total effective rate of menstrual recovery among the three groups(P>0.05).The degree of intrauterine adhesions in group C was lower than that in group A and group B after 6 weeks and 12 weeks of treatment significantly(P<0.05),while there was no significant difference between group A and group B(P>0.05).After 2 weeks,6 weeks and 12 weeks of treatment,the concentration of estrogen in group C was significantly higher than that of group A and group B,and group B was significantly higher than group A(P<0.05).After 2 weeks,6 weeks and 12 weeks treatment,the endometrial thickness of the three groups were all significantly higher than before(P<0.05).There was no significant difference in the endometrial thickness of the three groups in the same period(P>0.05).1 year after treatment,the pregnancy rate of group A was 28.89%(13/45),the pregnancy rate of group B was 31.

关 键 词：雌激素 宫腔粘连 子宫内膜厚度 月经 

分 类 号：R711.74[医药卫生—妇产科学]