雌孕激素序贯疗法联合宫腔镜下宫腔粘连分离术治疗宫腔粘连的效果  

Effect of sequential therapy of estrogen and progesterone combined with hysteroscopic transcervical resection of adhesions in the treatment of intrauterine adhesions

作　　者：魏红 黄钰华 WEI Hong;HUANG Yuhua(Shaanxi Kangfu Hospital,Xi'an 710065;Norinco General Hospital,Xi'an 710065,China)

机构地区：[1]陕西省康复医院,陕西西安710065 [2]兵器工业总医院,陕西西安710065

出　　处：《临床医学研究与实践》2024年第30期61-64,共4页Clinical Research and Practice

摘　　要：目的分析雌孕激素序贯疗法联合宫腔镜下宫腔粘连分离术(TCRA)治疗宫腔粘连的效果。方法选择2019年2月至2022年2月收治的46例宫腔粘连患者作为研究对象,根据治疗方法不同将其分为对照组(22例)和观察组(24例)。两组均给予宫腔镜下TCRA并植入宫内节育器,对照组给予常规治疗,观察组在对照组基础上应用雌孕激素序贯疗法。比较两组的治疗效果。结果治疗后,两组的子宫内膜厚度、内膜血管指数(VI)、血流指数(FI)、血管化血流指数(VFI)均升高,搏动指数(PI)、阻力指数(RI)均降低,且观察组优于对照组(P<0.05)。治疗后,两组的雌二醇(E_(2))、基质金属蛋白酶-9(MMP-9)水平均升高,转化生长因子-β1(TGF-β1)、金属蛋白酶组织抑制物-1(TIMP-1)水平均降低,且观察组优于对照组(P<0.05)。观察组的治疗总有效率、月经改善率及妊娠成功率高于对照组(P<0.05);治疗后,两组的宫腔粘连评分均降低,且观察组低于对照组(P<0.05)。结论雌孕激素序贯疗法联合宫腔镜下TCRA治疗宫腔粘连的临床效果显著,可改善月经情况、血清学指标及子宫血流参数,增加子宫内膜厚度,提高妊娠率。Objective To analyze the effect of sequential therapy of estrogen and progesterone combined with hysteroscopic transcervical resection of adhesions(TCRA)in the treatment of intrauterine adhesions.Methods A total of 46 patients with intrauterine adhesions admitted from February 2019 to February 2022 were selected as the research objects and divided into control group(22 cases)and observation group(24 cases)according to different treatment methods.Both groups were given TCRA under hysteroscopy and intrauterine device implantation,the control group was given routine treatment,and the observation group was treated with sequential therapy of estrogen and progesterone on the basis of the control group.The therapeutic effects of the two groups were compared.Results After treatment,the endometrial thickness,vascularization index(VI),flow index(FI)and vascularization flow index(VFI)in the two groups increased,while the pulsatility index(PI)and resistance index(RI)decreased,and those in the observation group were better than the control group(P<0.05).After treatment,the levels of estradiol(E_(2))and matrix metalloproteinase-9(MMP-9)in the two groups increased,while the levels of transforming growth factor-β1(TGF-β1)and tissue inhibitor of metalloproteinases-1(TIMP-1)decreased,and those in the observation group were better than the control group(P<0.05).The total effective rate of treatment,menstrual improvement rate and pregnancy success rate in the observation group were higher than those in the control group(P<0.05);after treatment,the score of intrauterine adhesions in both groups decreased,and that in the observation group was lower than the control group(P<0.05).Conclusion Sequential therapy of estrogen and progesterone combined with hysteroscopic TCRA in the treatment of intrauterine adhesions has a significant clinical effect,which can improve menstruation,serological indicators and uterine blood flow parameters,increase endometrial thickness and improve pregnancy rate.

关 键 词：宫腔镜下宫腔粘连分离术 雌孕激素序贯疗法 宫腔粘连 

分 类 号：R713[医药卫生—妇产科学]