透明质酸钠凝胶联合戊酸雌二醇预防高危人工流产术后宫腔粘连效果及对炎症因子水平的影响  

Effect of sodium hyaluronate gel combined with estradiol valerate for preventing intrauterine adhesion of women after high?risk abortion and its impact on the levels of inflammatory factors of the women

作　　者：万颖 贾丽华 魏占超 WAN Yin;JIA Lihua;WEI Zhanchao(Tongzhou Maternal and Child Health Care Hospital of Beijing,Beijing,101100)

机构地区：[1]北京市通州区妇幼保健院,101100

出　　处：《中国计划生育学杂志》2023年第7期1557-1561,共5页Chinese Journal of Family Planning

摘　　要：目的:探究透明质酸钠凝胶联合戊酸雌二醇对高危人工流产术后宫腔粘连的预防效果及对炎症因子水平的影响。方法:选取2020年5月—2022年5月在本院行高危人工流产术者120例,随机分为对照组(60例)和联合组(60例)。两组均给予透明质酸钠凝胶治疗,联合组加以戊酸雌二醇口服治疗。比较两组月经复潮时间、出血时间、出血量及异常子宫出血、宫颈粘连程度、血清宫颈粘连指标、人血管内皮生长因子(VEGF)、人转化生长因子(TGF-β)、人层连蛋白/板层素(LN)、人纤连蛋白(FN),血液流变学指标全血黏度、血浆黏度,炎症因子白细胞介素18(IL-18)、IL-10水平及不良反应。结果:术后3个月,联合组宫颈粘连率(3.3%)低于对照组(16.7%),两组治疗后血清VEGF、TGF-β、LN、FN、IL-18水平、全血黏度、血浆黏度均升高,IL-10水平均降低,但联合组变化幅度小于对照组(均P<0.05);两组异常子宫出血占比(16.7%、25.0%)、不良反应总发生率(5.0%、11.8%)无差异(P>0.05);联合组月经复潮时间(25.1±2.5d)、阴道出血时间(4.7±0.6d)、月经出血量(45.7±4.7ml)均低于对照组(28.6±2.9d、5.1±0.6d、48.5±4.9ml)(均P<0.05)。结论:透明质酸钠凝胶联合戊酸雌二醇用于高危人工流产术后可有效提高宫腔粘连改善程度,减少子宫异常出血,减轻炎症反应,促进恢复,安全有效。Objective:To explore the effect of sodium hyaluronate gel combined with estradiol valerate for preventing intrauterine adhesion of women after high-risk abortion,and to study its impact on the levels of inflammatory factors of the women.Methods:A total of 120women who had undergone the high-risk abortion were selected and randomly divided into two groups(60cases in each group)from May 2020to May 2022.The women in the control group were treated with sodium hyaluronate gel,and the women in the study group were treated with sodium hyaluronate gel combined with estradiol valerate.The time of menstruation recovery,the bleeding time,the bleeding volume,the abnormal uterine bleeding rate,the degree of cervical adhesion,the values of serum cervical adhesion indexes,the levels of human vascular endothelial growth factor(VEGF),human transforming growth factor(TGF-β),human laminin(LN),and human fibronectin(FN),the values of hemorheological indexes,such as whole blood viscosity and plasma viscosity,the levels of inflammatory factors,such as interleukin 18(IL-18)and leukocyte Interleukin-10(IL-10),and the incidence of adverse reactions of the women were compared between the two groups.Results:The cervical adhesion rate(3.3%)of the women in the study group in the 3rd month after surgery was significantly lower than that(16.7%)of the women in the control group.After treatment,the levels of serum VEGF,TGF-β,LN,FN,and IL-18,and the values of whole blood viscosity and plasma viscosity of the women in both groups had increased significantly,while the IL-10level of the women in both groups had decreased significantly,and the change ranges of which of the womenin the study group were significantly less than those of the women in the control group(all P<0.05).There were no significant differences in the proportion of abnormal uterine bleeding(16.7%vs.25.0%)and the total incidence of adverse reactions(5.0%vs.11.8%)of the women between the two groups(P>0.05).The duration of menstruation(25.1±2.5d),the duration of vaginal bleeding(4.7

关 键 词：高危人工流产术 宫腔粘连 戊酸雌二醇 透明质酸钠凝胶 疗效 炎症因子 

分 类 号：R169.42[医药卫生—公共卫生与预防医学]