宫腔粘连治疗的新进展  

Advances of Therapy for Intrauterine Adhesions

作　　者：姚欣怡 俞凌(审校)[2] YAO Xin-yi;YU Ling(Medical School of Chinese People′s Liberation Army,Department of Obstetrics and Gynecology,The First Medical Center,General Hospital of Chinese People′s Liberation Army,Beijing 100039,China;General Hospital of Chinese People′s Liberation Army,Beijing 100039,China)

机构地区：[1]中国人民解放军医学院,中国人民解放军总医院第一医学中心妇产科,北京100039 [2]中国人民解放军总医院

出　　处：《国际生殖健康／计划生育杂志》2023年第5期431-436,共6页Journal of International Reproductive Health/Family Planning

基　　金：军队后勤科研项目计划生育专项课题(23JSZ14)。

摘　　要：宫腔粘连(intrauterine adhesions,IUA)目前常用的治疗方法是宫腔镜下宫腔粘连分离术,但术后复发率高,术后子宫内膜损伤的风险也较高。药物治疗包括口服雌激素、他莫昔芬、阿司匹林、皮下注射促性腺激素释放激素激动剂及宫腔注入低剂量人绒毛膜促性腺激素等,疗效不稳定、治疗周期长。近年来,细胞治疗和再生医学的发展为IUA的治疗提供了新的研究方向。据报道,宫腔灌注或静脉输注干细胞悬液、宫腔内灌注富血小板血浆和生长因子及相关生物材料有较好的治疗效果。以细胞治疗为基础的多种新型辅助治疗措施逐渐应用于IUA治疗,成为理想的预防再粘连的方法;配合凝胶、支架等生物材料,为难治性IUA提供了新的治疗思路。The commonly used treatment method for intrauterine adhesions(IUA)is hysteroscopic transcervical resection of adhesion,but the postoperative recurrence rate is high,and the risk of postoperative endometrial injury is also high.The curative effect of drugs,including oral estrogen,tamoxifen,aspirin,subcutaneous injection of GnRH agonists,intrauterine injection of the low dose of human chorionic gonadotropin,etc.,is unstable,while the treatment cycle is long.In recent years,the development of cell therapy and regenerative medicine has provided a new research direction for the treatment of IUA.Good therapeutic effects of intrauterine perfusion or intravenous infusion of stem cell suspension,intrauterine infusion of platelet-rich plasma,growth factors and related biological materials have been reported.A variety of new adjuvant therapy measures developed on the basis of cell therapy have been gradually applied in the practice of IUA treatment,as the ideal methods to prevent readhesion.Combined with gels,scaffolds and other biological materials,these adjuvant measures also provide a new treatment idea for the refractory IUA.

关 键 词：干细胞 富血小板血浆 组织工程 宫腔镜检查 再生医学 宫腔粘连 

分 类 号：R711.74[医药卫生—妇产科学]