宫腔粘连分离术后预防再粘连的三种不同方法的临床疗效观察

发布时间：2018-04-19 07:07

本文选题：宫腔粘连 + 预防　；参考：《广西医科大学》2017年硕士论文

【摘要】：目的:通过收集宫腔粘连患者的临床资料,比较三种不同治疗方法的疗效,探讨宫腔镜下宫腔粘连分离术后预防再粘连的治疗方法。方法:回顾性分析2015年1月~2016年11月广西医科大学第一附属医院计划生育科收治的103例在宫腔镜下证实为宫腔粘连患者的临床资料,按宫腔镜下宫腔粘连分离术后预防再粘连治疗方法的不同分为A组(46例)、B组(34例)和C组(23例)。A组为节育环(IUD)+雌孕激素序贯治疗,B组为IUD+宫腔灌注粒细胞刺激因子(G-CSF)+雌孕激素序贯治疗,C组为Foley球囊+宫腔灌注G-CSF+雌孕激素序贯治疗。三组病人术后均在宫腔内保留透明质酸凝胶3-5ml。在术后第3个月返院行宫腔镜二次探查术,并记录宫腔重构情况、子宫内膜厚度、月经恢复情况等。三个月后则通过电话随防患者妊娠情况。所有的数据采用SPSS 22.0进行统计学处理。结果:1、患者的一般资料(年龄、人流次数、体重、孕次、宫腔操作次数、发病时间、术前子宫内膜厚度、宫腔粘连程度、就诊原因)对比差异无统计学意义(P0.05)。2、在宫腔镜下宫腔粘连分离术后治疗有效率、宫腔重构有效率、妊娠率三组间比较差异均无统计学意义(p0.05)。结论:宫腔镜下宫腔粘连分离术后,留置IUD、留置IUD+宫腔灌注GCSF、留置Foley球囊+宫腔灌注G-CSF,同时辅以雌孕激素序贯治疗和透明质酸钠治疗均能有效预防宫腔再粘连,且在治疗有效率、宫腔重构有效率、妊娠率上比较无明显差异。
[Abstract]:Objective: to collect the clinical data of patients with intrauterine adhesions and to compare the curative effects of three different treatment methods and to explore the treatment methods of preventing readhesions after hysteroscopic separation of intrauterine adhesions.Methods: the clinical data of 103 patients with intrauterine adhesion confirmed by hysteroscopy were analyzed retrospectively from January 2015 to November 2016 in the Family Planning Department of the first affiliated Hospital of Guangxi Medical University.According to the different methods of preventing and treating readhesion after hysteroscopy, the patients were divided into two groups: group A (n = 46) and group C (n = 23). Group A (n = 23) was treated with estradiol and progesterone. Group B was treated with granulocyte stimulation by intrauterine perfusion of IUD.Group C was treated with Foley balloon intrauterine infusion of G-CSF.Hyaluronic acid gel 3-5 ml was retained in uterine cavity after operation in all three groups.In the third month after operation, hysteroscopic second exploration was performed, and uterine cavity remodeling, endometrial thickness and menstrual recovery were recorded.Three months later, the patient was followed by telephone to prevent pregnancy.All data were statistically processed using SPSS 22. 0.Results: 1. General data of patients (age, number of abortion, weight, pregnancy, number of uterine cavity operations, onset time, preoperative endometrial thickness, degree of intrauterine adhesion,There was no significant difference between the three groups (P 0.05). There was no significant difference between the three groups in the effective rate of treatment, the effective rate of uterine cavity remodeling and the pregnancy rate of the three groups under hysteroscopy.Conclusion: after intrauterine adhesion separation under hysteroscopy, intrauterine IUD, IUD intrauterine perfusion, Foley balloon intrauterine perfusion, combined with sequential treatment of estrogen and progesterone and sodium hyaluronate can effectively prevent intrauterine adhesions.There was no significant difference in the effective rate of treatment, the effective rate of uterine cavity remodeling and pregnancy rate.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R713.4

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