妊娠中期清宫术后应用经皮雌二醇凝胶联合宫安康预防宫腔粘连的效果探究  

Effects of transdermal estradiol gel combined with Gongankang on preventing intrauterine adhesions after uterine curettage in the second trimester of pregnancy

作　　者：冯云玲 刘现红[1] Feng Yun-ling;Liu Xian-hong(Department of Obstetrics and Gynecology,The People’s Hospital of Anyang,Anyang 455100,Henan,China)

机构地区：[1]安阳市人民医院妇产科,河南安阳455100

出　　处：《四川生理科学杂志》2024年第2期336-339,共4页Sichuan Journal of Physiological Sciences

基　　金：2021年度河南省医学科技攻关计划联合共建项目(编号:LHGJ20210875)。

摘　　要：目的:探究经皮雌二醇凝胶联合宫安康在妊娠中期清宫术后对预防宫腔粘连的应用。方法:选取我院2021年1月至2022年11月接受人工流产或引产的71例患者,按照单双号法随机分为联合组(n=35)和对照组(n=36)。对照组患者接受宫安康0.05 g·kg^(-1)及常规抗感染治疗3 d,联合组在对照组基础上联用经皮雌二醇凝胶0.05 g·kg^(-1),Qd进行治疗。治疗2 m后采用宫腔镜检查宫腔粘连发生率及粘连严重程度,采用化学发光法测定激素水平,包括促黄体生成素(Luteinizing hormone,LH)、促卵泡生成素(Follicle stimulating hormone,FSH)、雌二醇(Estradiol2,E2)水平;采用酶检测法测定白细胞介素-10(Interleukin-10,IL-10)、白细胞介素-6(Interleukin-6,IL-6)及白细胞介素-4(Interleukin-4,IL-4)水平;采用阴道B超测定患者子宫内膜厚度,记录并比较两组经过治疗后月经复潮时间、复潮量变化以及不良反应发生情况。结果:治疗后,联合组宫腔粘连发生率、复潮时间明显低于对照组(P<0.05);与治疗前相比,各治疗组LH、FS、E2、IL-4、IL-10水平、子宫内膜厚度均明显增加(P<0.05),其中联合组更为显著(P<0.05);各治疗组IL-6水平均明显降低(P<0.05),其中联合组更为显著(P<0.05);治疗后,两治疗组不良反应发生情况相近(P>0.05)。结论:妊娠中期接受清宫术后患者使用经皮雌二醇凝胶可降低发生宫腔粘连的风险,减轻炎症反应,并改善子宫环境。Objective:To explore the application of transdermal estradiol gel combined with Gongankang(uterine crosslinked sodium hyaluronate gel)in the prevention of intrauterine adhesions after uterine curettage in the second trimester of pregnancy.Methods:Seventy-one patients who received artificial abortion or induced labor in the hospital from January 2021 to November 2022 were selected and randomly divided into the combined group(n=35)and the control group(n=36)according to the odd-even number method.The patients in the control group received 0.05 g·kg^(-1) of Gongankang and 3 days of conventional anti-infection treatment,and the patients in the combined group were treated with 0.05 g·kg^(-1) of transdermal estradiol gel once a day based on the control group.After 2 months of treatment,hysteroscopy was used to observe the incidence rate and severity of intrauterine adhesions.Hormones including luteinizing hormone(LH),follicle-stimulating hormone(FSH),and estradiol(E2)levels were measured by chemiluminescence assay.The levels of interleukin-10(IL-10),interleukin-6(IL-6)and interleukin-4(IL-4)were measured by enzyme method.The endometrial thickness was measured by vaginal B-ultrasound,and the menstruation recovery time,menstruation volume,and occurrence of adverse reactions after treatment were recorded and compared between the two groups.Results:After treatment,the incidence rate of intrauterine adhesions and menstruation recovery time in the combined group were significantly lower or shorter than those in the control group(P<0.05).Compared with before treatment,the levels of LH,FS,E2,IL-4,and IL-10 and endometrial thickness in both groups were significantly increased(P<0.05),and the above indicators were more significant in the combined group(P<0.05).The level of IL-6 was significantly decreased in both groups(P<0.05),and the change was more obvious in the combined group(P<0.05).After treatment,the adverse reactions were similar in the two groups(P>0.05).Conclusion:The application of transdermal estradiol gel after u

关 键 词：宫腔手术 预防 宫腔粘连 经皮雌二醇凝胶 宫安康 

分 类 号：R713.4[医药卫生—妇产科学]