两种宫腔屏障用于宫腔粘连术后的临床效果观察

发布时间：2018-11-25 20:44

【摘要】：目的探讨两种宫腔屏障用于中重度宫腔粘连(intrauterine adhesion,IUA)行宫腔镜下宫腔粘连分离术(transcervical resection of adhesions,TCRA)后的临床效果。方法选取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,按术后构建宫腔屏障方法的不同按随机数字表法分为两组。观察组:术毕宫腔放置Foley球囊+自交联透明质酸钠凝胶,术后1 d取出球囊,1周后宫腔镜探查并再次注入自交联凝胶;对照组:术毕放置Foley球囊+普通医用透明质酸钠凝胶,术后1周取出球囊,宫腔镜探查,置入宫内节育器及普通透明质酸钠凝胶。所有患者均行人工周期治疗。观察术后3月各组宫腔粘连AFS评分及治疗有效率、宫腔再粘连率。结果两组患者术后3个月时AFS总分和粘连范围、粘连类型、月经状况单项评分均较术前明显下降,差异均有统计学意义(P0.05)。两组间比较,观察组AFS总分、月经状况评分、再粘连率均低于对照组,治疗有效率高于对照组,差异均有统计学意义(P0.05)。结论 TCRA术后应用Foley球囊+自交联透明质酸钠凝胶作为宫腔屏障,是提高IUA疗效的有效方法。
[Abstract]:Objective to investigate the clinical effect of two kinds of uterine cavity barrier after (transcervical resection of adhesions,TCRA for moderate and severe intrauterine adhesions (intrauterine adhesion,IUA). Methods from January 2016 to June 2016, 52 patients with moderate or severe intrauterine adhesions were selected from Hubei Maternal and Child Health Hospital. According to the different methods of constructing uterine cavity barrier after operation, 52 patients were divided into two groups by random digital table. In the observation group, Foley balloon self-crosslinked sodium hyaluronate gel was placed in uterine cavity at the end of operation. The balloon was removed 1 day after operation, and the self-crosslinked gel was re-injected into hysteroscopy after 1 week. In the control group, the Foley balloon sodium hyaluronate gel was placed at the end of the operation. The balloon was removed 1 week after operation, and the intrauterine device and sodium hyaluronate gel were implanted through hysteroscopy. All patients were treated with artificial cycle therapy. The AFS score, the effective rate and the rate of intrauterine adhesions were observed 3 months after operation. Results at 3 months after operation, the total score of AFS, the adhesion range, the type of adhesion and the single score of menstrual status were significantly decreased in the two groups compared with those before operation (P0.05). Comparison between the two groups, the observation group AFS total score, menstrual status score, re-adhesion rate were lower than the control group, the effective rate was higher than the control group, the difference was statistically significant (P0.05). Conclusion Foley self-crosslinking sodium hyaluronate gel is an effective method to improve the efficacy of IUA after TCRA.
【作者单位】：湖北省妇幼保健院妇科;
【基金】：湖北省科技厅自然科学基金指导项目(2011CDC070)~~
【分类号】：R713.4

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