交联透明质酸钠凝胶在预防宫腔粘连术后再粘连中的应用

发布时间：2018-05-29 09:32

本文选题：宫腔粘连 + 透明质酸　；参考：《重庆医科大学学报》2017年04期

【摘要】：目的:探讨交联透明质酸钠凝胶在预防中重度宫腔粘连(intrauterine adhesion,IUA)术后再粘连中应用的效果。方法:采用前瞻性随机对照设计,选取2016年1月至2016年6月湖北省妇幼保健院收治的中重度宫腔粘连患者52例,随机分为2组。所有患者均行宫腔镜下宫腔粘连分离术(transcervical resection of adhesions,TCRA)。观察组:26例,术毕宫腔放置Foley球囊+宫腔用交联透明质酸钠凝胶,次日取出球囊,1周后复查宫腔镜并再次注入交联透明质酸钠凝胶;对照组:26例,术毕放置Foley球囊+普通医用透明质酸钠,术后1周取出球囊,复查宫腔镜并放置宫内节育器。所有患者均行人工周期治疗,每月行宫腔镜复查。观察术后3个月2组患者宫腔恢复、宫腔再粘连及月经改善情况。结果:观察组宫腔恢复率80.8%(21/26),对照组宫腔恢复率50.0%(13/26),差异有统计学意义(P=0.02)。观察组宫腔再粘连率3.8%(1/26),对照组26.9%(7/26);观察组月经改善率84.6%(22/26),对照组61.5%(16/26),但2组比较,差异无统计学意义(P0.05)。2组治疗效果比较,经U检验差异有统计学意义(P=0.01)。结论:TCRA术后宫腔使用交联透明质酸钠凝胶作为生物屏障,辅助雌激素修复子宫内膜可有效改善宫腔恢复率及IUA治疗效果,是预防宫腔再粘连的有效方法。
[Abstract]:Objective: to investigate the effect of cross-linked sodium hyaluronate gel in preventing intrauterine adhesion after intrauterine adhesion (IUAA). Methods: a prospective randomized controlled design was used to select 52 patients with moderate or severe intrauterine adhesion from January 2016 to June 2016 in Hubei Maternal and Child Health Care Hospital, and were randomly divided into 2 groups. All patients were treated with transcervical resection of adhesions under hysteroscopy. In the observation group, 26 cases were treated with Foley balloon intrauterine cavity after operation, and then treated with sodium hyaluronate gel. The next day, the hysteroscopy was taken out one week later and the cross-linked sodium hyaluronate gel was injected again in the control group (n = 26), while the control group (n = 26) was treated with sodium hyaluronate gel. Foley balloon sodium hyaluronate was placed at the end of the operation. The balloon was removed 1 week after operation, and the hysteroscopy was re-examined and intrauterine device was placed. All patients were treated with manual cycle therapy, and hysteroscopy was performed monthly. The recovery of uterine cavity, re-adhesion of uterine cavity and menorrhagia were observed 3 months after operation. Results: the recovery rate of uterine cavity in the observation group was 80.8%, and the recovery rate in the control group was 50.0%. The difference was statistically significant. In the observation group, the rate of uterine cavity readhesion was 3.8g / 26g, the control group was 26.9g / 26g, the menorrhagia improvement rate of the observation group was 84.6n22 / 26g, and the control group 61.5g / 26, but the difference between the two groups was not statistically significant (P 0.05), but there was a significant difference between the two groups (P 0.05N), but there was a significant difference between the two groups (P 0.01). Conclusion the use of cross-linked sodium hyaluronate gel as a biological barrier in uterine cavity after TCR A can effectively improve the recovery rate of uterine cavity and the therapeutic effect of IUA. It is an effective method to prevent uterine cavity re-adhesion.
【作者单位】：湖北省妇幼保健院妇科;首都医科大学附属北京妇产医院;
【基金】：湖北省科技厅自然科学基金资助项目(编号:2011CDC070)
【分类号】：R713.4

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