宫腔球囊联合宫腔用交联透明质酸钠凝胶在子宫腔粘连冷刀分离术后患者中的应用  

Application of uterine cavity balloon and intrauterine crosslinked sodium hyaluronate gel in patients with intrauterine adhesion undergoing cold knife separation

作　　者：洪桂珍 莫桂花 王春玲 蔡美燕 Hong Guizhen;Mo Guihua;Wang Chunling;Cai Meiyan(Department of Gynecology,the 924 Hospital of the Joint Logistics Support Force of the Chinese People’s Liberation Army,Guilin Guangxi 541002,China)

机构地区：[1]中国人民解放军联勤保障部队第九二四医院妇科,广西桂林541002

出　　处：《中国医刊》2025年第2期168-171,共4页Chinese Journal of Medicine

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z-C20221062)。

摘　　要：目的探讨宫腔球囊联合宫腔用交联透明质酸钠凝胶在子宫腔粘连(IUA)冷刀分离术后患者中的应用效果。方法选取中国人民解放军联勤保障部队第九二四医院于2020年6月至2022年6月收治的84例IUA患者为研究对象,采用随机数字表法分为对照组和观察组两组,每组42例。两组患者均进行宫腔镜下冷刀分离术,对照组术后注入宫腔用交联透明质酸钠凝胶,观察组术后注入宫腔用交联透明质酸钠凝胶,随后放置宫腔球囊。评估两组患者的临床疗效,采用美国生殖协会(AFS)评分评估两组患者治疗前后的粘连累及宫腔范围、粘连类型、月经类型,采用超声测量两组患者治疗前后排卵期子宫内膜的厚度。对两组患者随访1年,记录妊娠结局(包括生化妊娠率、临床妊娠率)。结果观察组的临床总有效率高于对照组,而生化妊娠率低于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者的粘连累及宫腔范围、粘连类型、月经类型等AFS评分比较差异均无统计学意义(P>0.05);治疗后,两组患者的粘连累及宫腔范围、粘连类型、月经类型等AFS评分均较治疗前降低,且观察组低于对照组,差异均有统计学意义(P<0.05)。治疗前,两组患者的子宫内膜厚度比较差异无统计学意义(P>0.05);治疗后,两组患者的子宫内膜厚度均较治疗前增厚,且观察组厚于对照组,差异均有统计学意义(P<0.05)。结论宫腔球囊联合宫腔用交联透明质酸钠凝胶可有效减少IUA冷刀分离术后患者的复发粘连,促进子宫内膜的修复,改善宫腔状态、月经量、生化妊娠率。Objective To investigate the application of uterine cavity balloon and intrauterine crosslinked sodium hyaluronate gel in patients with intrauterine adhesion undergoing cold knife separation.Method A total of 84 patients with uterine adhesion admitted to the 924 Hospital of the Joint Logistics Support Force of the Chinese People’s Liberation Army from June 2020 to June 2022 were randomly grouped into control group(42 cases)and observation group(42 cases)underwent hysteroscopic cold knife separation.The control group was injected with intrauterine crosslinked sodium hyaluronate gel after surgery,and the observation group was implanted with gel and balloon uterine stent after surgery.The clinical efficacy of two groups of treatments was evaluated;the American Fertility Society(AFS)scoring system was applied to score the extent of adhesions in the uterine cavity,types of adhesions,and menstrual types before and after treatment in two groups;the ultrasound was applied to measure the thickness of the endometrium during ovulation in two groups before and after treatment;both groups were followed up to record the pregnancy outcomes.Result The total effective rate of the observation group was higher,while the biochemical pregnancy rate was lower,with statistical significance(P<0.05).After treatment,the range of adhesions involved in the uterine cavity,types of adhesions,and menstrual typescores in both groups were reduced,moreover,the observation group had lower scores for adhesions involving the uterine cavity,types of adhesions,and menstrual types compared to the control group,with statistical significance(P<0.05).Intimal thickening after treatment in both groups,and the thickness of intima in the observation group was higher than the control group,with statistical significance(P<0.05).Conclusion Uterine cavity balloon and intrauterine crosslinked sodium hyaluronate gel can effectively reduce the recurrence of adhesions in patients with cold knife separation of uterine adhesion,promote the repair of endometrium,and i

关 键 词：子宫腔粘连 再粘连 宫腔球囊 冷刀分离术 宫腔用交联透明质酸钠凝胶 月经 

分 类 号：R713.4[医药卫生—妇产科学]