生物防粘连膜和宫内节育器预防中重度宫腔粘连术后再粘连效果的比较

发布时间：2018-08-07 18:15

【摘要】：目的:探究宫腔粘连分离术后宫腔内置入包裹生物防粘连膜的宫内节育器(intrauterine device,IUD)与防粘连膜预防粘连复发的疗效。方法:回顾性分析2015年7月至2016年7月重庆医科大学附属第一医院经宫腔镜检查诊断为中重度IUA患者120例,于宫腔镜粘连分离术后被随机分为A组(包裹生物防粘连膜的金属圆形IUD被置入宫腔)70例,B组(生物防粘连膜被置入宫腔)50例。对照2组患者术后的再粘连形成、月经量的变化、宫腔解剖构造恢复、妊娠情况。结果:术后A组宫腔再粘连发生率(37.1%)明显低于B组再粘连发生率(56.0%),P=0.041;A、B组妊娠率分别为22.9%、22.0%(P=0.912);A、B组月经量治疗有效率(治愈率+改善率)分别为72.9%、62.0%(P=0.523);A、B组宫腔形态恢复有效率(治愈率+改善率)分别为100%、98%(P=0.554)。结论:术后宫腔内留置金属圆形IUD+生物防粘连膜防止粘连复发的效果明显优于单纯放置防粘连膜,而对于改善月经、恢复宫腔解剖结构及妊娠,2种方法均可。
[Abstract]:Objective: to investigate the effect of intrauterine device and antiadhesion membrane after intrauterine adhesion separation. Methods: from July 2015 to July 2016, 120 patients with moderate and severe IUA diagnosed by hysteroscopy in the first affiliated Hospital of Chongqing Medical University were analyzed retrospectively. After hysteroscopic adhesion separation, 50 cases were randomly divided into group A (70 cases with biofilm enclosing metallic circular IUD implanted into uterine cavity) and group B (50 cases with biofilm implanted into uterine cavity). The readhesions, menstrual volume, anatomic structure of uterine cavity and pregnancy were observed in the control group. Results: the incidence of intrauterine re-adhesion in group A (37.1%) was significantly lower than that in group B (56.0%). The pregnancy rate of group A was 22.90.22% (P 0.912) the effective rate of menstrual volume therapy (cure rate) was 72.9% (P 0.523) and the rate of recovery of uterine cavity in group A was 72.9% (P 0.523). The cure rate was 100 / 98% (P < 0. 554). Conclusion: the effect of intrauterine indwelling metal circular IUD biofilm to prevent the recurrence of adhesion is better than that of simple placement of anti-adhesion membrane, but it can be used to improve menstruation, restore the anatomic structure of uterine cavity and pregnancy.
【作者单位】：重庆医科大学附属第一医院妇产科;
【基金】：国家自然科学基金资助项目(编号:81471417)
【分类号】：R713.4

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