戊酸雌二醇预处理联合宫腔镜手术治疗中重度宫腔粘连的效果  

Effect of Estradiol Valerate Pretreatment Combined with Hysteroscopic Surgery in the Treatment of Moderate and Severe Intrauterine Adhesions

作　　者：欧阳彦兰 OUYANG Yanlan(Huizhou First Maternal and Child Health Care Hospital,Guangdong Province,Huizhou 516007,China)

机构地区：[1]广东省惠州市第一妇幼保健院,广东惠州516007

出　　处：《中国医学创新》2023年第13期35-39,共5页Medical Innovation of China

基　　金：惠州市科技计划项目(20210403)。

摘　　要：目的:探讨戊酸雌二醇预处理联合宫腔镜手术在治疗中重度宫腔粘连的临床应用。方法:前瞻性选取惠州市第一妇幼保健院2021年3月-2022年1月收治的56例中重度宫腔粘连患者,按照随机数字表法分为常规组和联合组,每组28例。两组均接受宫腔镜手术治疗,常规组在术后予以戊酸雌二醇治疗,联合组在常规组基础上予以戊酸雌二醇预处理治疗,观察两组患者子宫形态恢复情况、子宫内膜血流、细胞因子水平、月经恢复正常时间及宫腔再粘连发生率。结果:术前,两组子宫内膜厚度及子宫体积对比,差异均无统计学意义(P>0.05);治疗结束后,两组子宫内膜厚度、体积均较术前增加,且联合组均高于常规组(P<0.05);联合组月经恢复正常时间短于常规组(P<0.05)。术前,两组血管化指数(vascularity index,VI)、血流指数(flow index,FI)、血流阻力指数(resistance index,RI)和血管搏动指数(pulsatility index,PI)对比,差异均无统计学意义(P>0.05);治疗结束后,两组RI、PI均较术前下降,且联合组均低于常规组,两组VI、FI均较术前上升,且联合组均高于常规组(P<0.05)。术前,两组血清转化生长因子-β_(1)(TGF-β_(1))、基质金属蛋白酶-9(MMP-9)水平及血管内皮生长因子(VEGF)水平对比,差异均无统计学意义(P>0.05);治疗结束后,两组TGF-β_(1)、VEGF及MMP-9均较术前下降,且联合组均低于常规组。术后3个月,联合组宫腔粘连再发生率(7.14%)低于常规组(28.57%)(P<0.05)。结论:戊酸雌二醇预处理联合宫腔镜手术治疗中重度宫腔粘连,可促进子宫形态恢复,缩短月经恢复正常时间,改善子宫血流,调节内皮因子水平,降低宫腔再粘连发生率。Objective:To investigate the clinical application of estradiol valerate pretreatment combined with hysteroscopy surgery in the treatment of moderate and severe intrauterine adhesions.Method:A total of 56 patients with moderate and severe intrauterine adhesions admitted to Huizhou First Maternal and Child Health Care Hospital from March 2021 to January 2022 were prospectively selected,and divided into conventional group and combined group according to random number table method,with 28 cases in each group.Both groups received hysteroscopy surgery.The conventional group was treated with Estradiol Valerate after surgery,while the combined group was treated with Estradiol Valerate pretreatment on the basis of the conventional group.The recovery of uterine morphology,endometrial blood flow,cytokine levels,the time of menstrual recovery to normal and the incidence of intrauterine re-adhesion were observed in both groups.Result:Before surgery,there were no significant differences in endometrial thickness and uterine volume between the two groups(P>0.05);after treatment,the endometrial thickness and volume of the two groups increased,and the combined group was higher than conventional group(P<0.05);the menstrual recovery time of the combined group was shorter than that of the conventional group(P<0.05).Before surgery,there were no significant differences in vascularity index(VI),flow index(FI),blood flow resistance index(RI)and pulsatility index(PI)between the two groups(P>0.05);after treatment,RI and PI of both groups were decreased and the combined group was lower than the conventional group,VI and FI of both groups were increased and the combination group was higher than the conventional group(P<0.05).Before surgery,there were no significant differences in serum levels of transforming growth factor-β_(1)(TGF-β_(1)),matrix metalloproteinase-9(MMP-9)and vascular endothelial growth factor(VEGF)between the two groups(P>0.05);after treatment,TGF-β_(1),VEGF and MMP-9 decreased in both groups,and the combined group was lo

关 键 词：中重度宫腔粘连 戊酸雌二醇 预处理 子宫内膜血流 

分 类 号：R713.4[医药卫生—妇产科学]