雌二醇凝胶联合芬吗通辅助宫腔粘连分离术后指标的研究  

Research on the indicators after TCRA with estradiol gel combined with femoston as an adjunctive therapy

作　　者：胡婧 陶冶 熊露露[1] 杨帆[1] HU Jing;TAO Ye;XIONG Lulu;YANG Fan(Jiujiang Maternal and Child Health Hospital,Jiujiang Children's Hospital,Jiujiang Maternal and Child Health Family Planning Service Center,Jiangxi,Jiujiang,332000,China;Joint Logistics Support Force Lushan Rehabilitation Center,Jiangxi,Jiujiang,332000,China)

机构地区：[1]九江市妇幼保健院,九江市儿童医院,九江市妇幼保健计划生育服务中心,九江332000 [2]联勤保障部队庐山康复疗养中心,九江332000

出　　处：《江西医药》2024年第12期1104-1107,共4页Jiangxi Medical Journal

基　　金：江西省卫生健康委科技计划,编号202410672。

摘　　要：目的 探究雌二醇凝胶联合芬吗通辅助宫腔镜下宫腔粘连分离术(TCRA)治疗中重度宫腔粘连的疗效及对术后血液流变学指标与内膜修复的影响。方法 选取2023年2月至2024年8月于我院间接受治疗的96例中重度宫腔粘连患者,按数字随机表法分为对照组和观察组,各48例。两组患者均进行TCRA治疗,其中对照组给予患者芬吗通辅助治疗,观察组患者在对照组的基础上联合雌二醇凝胶辅助治疗。比较两组治疗效果、宫腔粘连评分、子宫内膜厚度、子宫内膜下动脉阻力指数(RI)、搏动指数(PI)、血液流变学指标[血浆黏度、全血低切黏度(BVL)、全血高切黏度(BVH)]及不良反应发生情况。结果 治疗后,两组月经恢复情况及宫腔形态恢复情况差异无统计学意义(P>0.05);两组患者治疗后子宫内膜厚度增加,RI、PI、BVL、BVH及血浆黏度均低于治疗前,且观察组的改善程度均优于对照组(P<0.05)。治疗中,观察组不良反应总发生率明显低于对照组(P<0.05)。结论 雌二醇凝胶联合芬吗通辅助TCRA治疗中重度宫腔粘连具有较好的临床疗效,可显著改善患者子宫动脉血流及血液流变学指标,促进月经和子宫内膜的恢复,且安全性较高,可进一步推广至临床应用。Objective To explore the efficacy of estradiol gel combined with femoston assisted trans-cervical resection of adhesions(TCRA)in the treatment of moderate and severe adhesiveness and the effect on postoperative hemorheology and endometrial repair.Methods A total of 96 patients with moderate to severe uterine adhesions who were treated in our hospital between February 2023 and August 2024 were prospectively selected and divided into control group and observation group according to the random number table method,48 cases in each group.Both groups of patients were treated with TCRA,in which patients in the control group were given fenmadone adjuvant therapy,and patients in the observation group were combined with estradiol gel adjuvant therapy on the basis of the control group.The treatment effect,uterine adhesion score,endometrial thickness,subendometrial artery resistance index(RI),pulsatility index(PI),blood rheology indexes[plasma viscosity,whole blood viscosity in low(BVL),whole blood viscosity in high(BVH)]and the occurrence of adverse reactions were compared between the two groups.Results After treatment,there were no significant differences in the recovery of menstruation and uterine shape between the two groups(P>0.05);the endometrial thickness of the patients in the two groups increased after treatment,and RI,PI,BVL,BVH and plasma viscosity were lower than those before treatment,and the degree of improvement in the observation group was better than that in the control group(P<0.05).In the treatment,the total incidence of adverse reactions in the observation group was significantly lower than that in the control group(P<0.05).Conclusion Estradiol gel combined with femoston assisted TCRA in the treatment of moderate and severe intrauterine adhesions has good clinical efficacy,can significantly improve the patientss’uterine artery blood flow and hemorheology indexes,and promote the recovery of menstrual and endometrial,and has high safety,which can be further promoted to clinical application.

关 键 词：雌二醇凝胶 芬吗通 宫腔粘连分离术 宫腔粘连 疗效 

分 类 号：R711[医药卫生—妇产科学]