宫腔粘连术后不同辅助治疗方案的应用效果对比  

Comparison of the Application Effect of Different Adjuvant Treatment Schemes After Intrauterine Adhesions

作　　者：张朝红[1] 高立[1] 杨蕾[1] 刘妍[1] ZHANG Chaohong;GAO Li;YANG Lei;LIU Yan(The Second Department of Gynecology,Baoji Maternal and Child Health Hospital,Baoji Shaanxi 721000,China)

机构地区：[1]宝鸡市妇幼保健院妇二科,陕西宝鸡721000

出　　处：《中国卫生标准管理》2025年第4期31-34,共4页China Health Standard Management

摘　　要：目的 探讨宫腔粘连(intrauterine adhesion,IUA)术后不同辅助治疗方案对子宫内膜生长的影响及再粘连的预防效果。方法 选取宝鸡市妇幼保健院2022年10月—2024年3月治疗的IUA术后需预防再粘连的患者147例,按照辅助治疗方案的差异分为A组(n=69)、B组(n=53)与C组(n=25)。A组予以宫腔注入自体富血小板血浆(platelet-rich plasma,PRP)干预,B组予以宫腔注入重组人粒细胞集落刺激因子注射液(granulocyte-colony stimulating factor,G-CSF)干预,C组予以仿生物电刺激疗法干预。对比3组再粘连发生情况、月经恢复情况、子宫内膜生长指标水平及妊娠率。结果 A组再粘连发生率为1.45%,较B组的11.32%与C组的20.00%均更低,差异有统计学意义(P<0.05)。A组、B组、C组月经恢复总有效率为95.65%、92.45%、84.00%,组间对比差异无统计学意义(P> 0.05)。治疗后A组子宫内膜厚度为(7.51±1.45)mm,高于B组的(6.49±1.34)mm与C组的(6.12±1.32)mm,差异有统计学意义(P <0.05)。治疗后A组子宫螺旋动脉搏动指数(pulsation index,PI)、阻力指数(resistance index,RI)为(2.02±0.37)、(0.80±0.09),低于B组的(2.32±0.49)、(0.85±0.12)与C组的(2.25±0.51)、(0.86±0.11),差异有统计学意义(P <0.05)。A组妊娠率为68.12%,高于B组的49.06%与C组的40.00%,差异有统计学意义(P <0.05)。结论 IUA术后不同辅助治疗方案的再粘连预防效果相当,但PRP疗法在提高妊娠率方面具有一定优势。Objective To explore the effect of different adjuvant treatment schemes on endometrial growth and the prevention effect of readhesion after intrauterine adhesions(IUA).Methods A total of 147 patients who needed to prevent readhesion after IUA were selected from Baoji Maternal and Child Health Hospital from October 2022 to March 2024,and were divided into group A(n=69),group B(n=53)and group C(n=25)according to the difference of adjuvant therapy.Group A was treated with intrauterine injection of autologous platelet-rich plasma(PRP),group B was treated with intrauterine injection of recombinant human granulocyte-colony stimulating factor(G-CSF),and group C was treated with simulated bioelectric stimulation therapy.The occurrence of readhesion,menstrual recovery,endometrial growth index level and pregnancy rate of the three groups were compared.Results The incidence of readhesion in group A was 1.45%,which was lower than that in group B(11.32%)and group C(20.00%),the differences were statistically significant(P<0.05).The total effective rate of menses recovery in groups A,B and C were 95.65%,92.45%and 84.00%,and there were not significant difference among groups(P>0.05).After treatment,the endometrial thickness of group A was(7.51±1.45)mm,which was higher than that of group B(6.49±1.34)mm and group C(6.12±1.32)mm.After treatment,the pulsation index(PI)and resistance index(RI)of spiral artery of uterus in group A were(2.02±0.37)and(0.80±0.09),which were lower than that of group B(2.32±0.49),(0.85±0.12)and group C(2.25±0.51),(0.86±0.11),the differences were statistically significant(P<0.05).The pregnancy rate of group C was 68.12%,which was higher than that of group A(49.04%)and group B(40.00%),the differences were statistically significant(P<0.05).Conclusion Different adjuvant therapy regimens have similar effect on the prevention of readhesion after IUA,but PRP therapy has certain advantages in improving the pregnancy rate.

关 键 词：宫腔粘连 再粘连 自体富血小板血浆 重组人粒细胞集落刺激因子注射液 仿生物电刺激疗法 妊娠 

分 类 号：R608[医药卫生—外科学]