宫腔镜电切术后球囊导尿管联合透明质酸钠凝胶对宫腔形态恢复、超声学指标的影响  

Effects of balloon catheter combined with sodium hyaluronate gel on uterine morphology recovery and ultrasonic indexes after hysteroscopic electrotomy

作　　者：杨霈馨 韦娜 吴敏[2] 孙言 王传杰 YANG Peixin;WEI Na;WU Min;SUN Yan;WANG Chuanjie(Department of Obstetrics and Gynecology,Suzhou BenQ Medical Center,the Affiliated BenQ Hospital of Nanjing Medical University,Suzhou 215010,Jiangsu,China;Department of Ultrasound,Suzhou BenQ Medical Center,the Affiliated BenQ Hospital of Nanjing Medical University,Suzhou 215010,Jiangsu,China;Nursing Department,Suzhou BenQ Medical Center,the Affiliated BenQ Hospital of Nanjing Medical University,Suzhou 215010,Jiangsu,China;Department of Obstetrics and Gynecology,Suzhou Science and Technology City Hospital,Suzhou 215009,Jiangsu,China)

机构地区：[1]南京医科大学附属明基医院苏州院区妇产科,江苏苏州215010 [2]南京医科大学附属明基医院苏州院区超声科,江苏苏州215010 [3]南京医科大学附属明基医院苏州院区护理部,江苏苏州215010 [4]苏州科技城医院妇产科,江苏苏州215009

出　　处：《中国性科学》2023年第1期97-100,共4页Chinese Journal of Human Sexuality

摘　　要：目的 观察球囊导尿管联合透明质酸钠凝胶对中重度宫腔粘连(IUA)患者宫腔镜电切术后宫腔形态恢复、超声学指标的影响。方法 选取2019年1月至2021年9月苏州明基医院收治的102例中重度IUA患者作为研究对象,随机分为观察组(n=51)和对照组(n=51)。两组均接受宫腔镜下IUA电切术治疗,对照组于术后置入Foley球囊导尿管预防再粘连,观察组则置入Foley球囊导尿管联合透明质酸钠凝胶注入预防再粘连。术后3个月时,比较两组美国生育学会(AFS)IUA评分、子宫内膜容积(EV)、血流指数(FI)、内膜厚度(ET)及宫腔形态恢复、再粘连发生情况。结果 术后3个月,两组粘连范围、粘连类型、月经模式评分及总分均较治疗前降低,且观察组粘连范围、月经模式评分及总分均低于对照组(P<0.05)。两组EV、ET及FI均较术前增加,且观察组均高于对照组(P<0.05)。观察组宫腔形态恢复正常比例高于对照组,再粘连发生率低于对照组(P<0.05)。结论 IUA电切术后使用Foley球囊导尿管联合透明质酸钠凝胶预防再粘连效果显著,有助于降低IUA严重程度,促进子宫形态恢复。Objective To observe the effects of balloon catheter combined with sodium hyaluronate gel on recovery of uterine morphology and ultrasonic indexes in patients with moderate to severe intrauterine adhesions(IUA) after hysteroscopic electrotomy. Methods 102 patients with moderate to severe IUA enrolled between January 2019 and September 2021 in Suzhou Mingji Hospital were randomly divided into observation group and control group, 51 cases in each group. Both groups underwent hysteroscopic electrotomy. After that, control group was implanted with Foley balloon catheter, while observation group was implanted with Foley balloon catheter combined with sodium hyaluronate gel injection to prevent re-adhesion. IUA score of American Fertility Society(AFS), endometrial volume(EV), flow index(FI), endometrial thickness(ET), recovery of uterine morphology and the occurrence of re-adhesion were compared at 3 months after surgery. Results Three months after surgery, the total score and scores of adhesion range, adhesion types and menstrual modes were all lower than those before treatment in both groups, and the total score and scores of adhesion range and menstrual modes in the observation group were lower than those in the control group(P<0.05). After surgery, EV, ET and FI in both groups were all increased(P<0.05), while the observation group had a more significant change(P<0.05). The proportion of cases with uterine morphology recovery was higher in observation group, while the proportion of re-adhesion was lower(P<0.05). Conclusions Foley balloon catheter combined with sodium hyaluronate gel is effctive in preventing re-adhesion after hysteroscopic electrotomy, which is beneficial to relieve IUA severity and promote the recovery of uterine morphology.

关 键 词：宫腔粘连 宫腔镜电切术 Foley球囊导尿管 透明质酸钠凝胶 

分 类 号：R711[医药卫生—妇产科学]