新鲜羊膜移植对中、重度宫腔粘连月经模式的影响

发布时间：2018-01-16 20:36

本文关键词：新鲜羊膜移植对中、重度宫腔粘连月经模式的影响　出处：《重庆医科大学学报》2017年04期 　论文类型：期刊论文

【摘要】：目的:探讨新鲜羊膜移植对中、重度宫腔粘连患者行宫腔镜宫腔粘连分离术(transcervical resection of adhesions,TCRA)后月经模式的影响。方法:选择2015年1至12月于我院宫腔镜检查确诊的46例表现为月经过少或闭经的中重度宫腔粘连患者,分为羊膜移植组(24例)和几丁糖组(22例)。羊膜移植组在TCRA术后行新鲜羊膜移植,几丁糖组在TCRA术后宫内注射几丁糖。术后1、3个月行B超及宫腔镜检查,随访观察子宫内膜厚度及月经改善情况。结果:所有患者手术过程均顺利且无相关并发症。羊膜移植组和几丁糖组患者月经完全或显著改善分别为87.5%(21/24)、50%(11/22);羊膜移植组总有效率为100%(24/24),几丁糖组总有效率为81.8%(18/22)。经统计分析,羊膜移植组子宫内膜厚度和月经持续时间优于几丁糖组,差异具有统计学意义(P1=0.002,P2=0.025);但2组月经改善总有效率比较,差异无统计学意义(P=0.096)。结论:TCRA术后将新鲜羊膜移植入宫腔能在一定程度上优化宫腔粘连患者月经情况,为宫腔粘连患者提高生育率提供了新的希冀。
[Abstract]:Objective: to investigate the effect of fresh amniotic membrane transplantation on amniotic membrane transplantation. Patients with severe intrauterine adhesions were treated with transcervical resection of adhesions. Methods: 46 patients diagnosed by hysteroscopy from 2015 to December were diagnosed as moderate or severe intrauterine adhesions with menorrhagia or amenorrhea. Amniotic membrane transplantation group was divided into amniotic membrane transplantation group (n = 24) and chitosan group (n = 22). Fresh amniotic membrane transplantation was performed in the amniotic membrane transplantation group and intrauterine injection of chitosan in the TCRA group. B ultrasound and hysteroscopy were performed for 3 months. Results: all the patients underwent the operation smoothly and had no related complications. The patients in amniotic membrane transplantation group and chitosan group had complete or significant improvement in menstrual cycle (87.5%). 21 / 24. 50 / 11 / 22; The total effective rate of amniotic membrane transplantation group was 100% 24 / 24, and that of chitosan group was 81.8%. The endometrium thickness and menstrual duration of amniotic membrane transplantation group were better than those of chitosan group, and the difference was statistically significant. But the total effective rate of menorrhagia improvement was compared between the two groups. Conclusion Transplantation of fresh amniotic membrane into uterine cavity after the operation of TCRA can improve menstruation in patients with intrauterine adhesion to a certain extent. It provides a new hope for the patients with intrauterine adhesion to increase the fertility rate.
【作者单位】：重庆医科大学附属大学城医院妇产科;
【基金】：重庆市卫生计生委医学科研项目(NO.20141014) 重庆市医疗特色专科建设项目(NO.2013-46)
【分类号】：R711.74
【正文快照】： 宫腔粘连(intrauterine adhesion,IUA)是因创伤、感染等因素破环子宫内膜基底层而导致内膜纤维化及瘢痕组织形成,继而引起月经过少、闭经、周期性下腹痛、不孕及产科并发症等[1],严重影响女性生殖健康。目前宫腔镜被认为是宫腔粘连诊断和治疗的金标准,其灵敏性及特异性比子宫

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