宫腔镜在人工流产术后宫腔粘连诊治中的效果评价

发布时间：2018-02-28 20:41

本文关键词： 人工流产术宫腔粘连雌激素宫腔粘连分离术　出处：《生殖医学杂志》2016年12期 　论文类型：期刊论文

【摘要】：目的探讨宫腔镜在人工流产术后宫腔粘连(IUA)诊治中的应用效果。方法回顾性分析我院生殖调节科2014年1月至2016年1月收治的因人工流产术后IUA行宫腔粘连分离术(TCRA)的85例患者的临床资料。根据IUA的程度不同分为3组:轻度粘连组、中度粘连组和重度粘连组。分别行腹腔镜监测下或B超监测下的TCRA术,术后放置宫内节育器(IUD)并给予常规激素序贯治疗,观察各组患者月经改善及宫腔恢复情况。结果 85例患者TCRA术后宫腔恢复正常者67例(78.8%),月经改善62例(72.9%)。轻度粘连与中度粘连患者比较,TCRA术后宫腔恢复率和月经改善率无显著性差异(P0.05);但轻度、中度粘连组术后的宫腔恢复率(分别为94.4%、76.3%)和月经改善率(分别为86.1%、73.7%)均显著高于重度粘连组(宫腔恢复率36.4%、月经改善率27.3%)(P0.05)。结论宫腔镜下TCRA联合术后放置IUD及雌-孕激素序贯治疗对人工流产术后IUA治疗效果良好,轻、中度IUA预后明显好于重度IUA。
[Abstract]:Objective to investigate the effect of hysteroscopy in the diagnosis and treatment of intrauterine adhesion (IUAA) after induced abortion. Methods retrospective analysis was made on the separation of intrauterine adhesions due to IUA after artificial abortion in our department of reproductive regulation from January 2014 to January 2016. The clinical data of 85 patients with IUA were divided into three groups according to the degree of IUA: mild adhesion group. The moderate adhesion group and the severe adhesion group were treated with TCRA under laparoscopy or B-ultrasound respectively, and intrauterine IUDs were placed after operation and were treated with routine hormone sequential therapy. Results Sixty-seven patients with normal uterine cavity after TCRA and 62 patients with menorrhagia improved their menstruation. The recovery rate of uterine cavity and menorrhagia after TCRA were compared between mild and moderate adhesions. There was no significant difference in good rate (P 0.05), but mild, The recovery rate of uterine cavity (94.4% 76.3) and menstrual improvement rate (86.1% 73.7%) in moderate adhesion group were significantly higher than those in severe adhesion group (36.4%, 27.3% P 0.05). Conclusion TCRA combined with IUD and female-pregnancy under hysteroscope is higher than that in severe adhesion group. The effect of hormone sequential therapy on IUA after artificial abortion was good. The prognosis of mild and moderate IUA was better than that of severe IUA.
【作者单位】：首都医科大学附属北京妇产医院生殖调节科;
【基金】：国家自然科学基金项目(81270733)
【分类号】：R713.4

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