摘要
目的:探讨圆形宫内节育器、COOK球囊支架、宫腔用交联透明质酸钠凝胶治疗中、重度宫腔粘连分离术后再粘连的疗效。方法:选择2014年1月—2019年1月在普宁市妇幼保健计划生育服务中心妇科住院部接受宫腔镜下宫腔粘连分离术的中、重度宫腔粘连患者128例。6组患者在宫腔镜下宫腔粘连分离术后给予戊酸雌二醇促进子宫内膜修复,并对患者进行随访。在综合治疗后第3个月时,观察其月经恢复情况,并进行宫腔镜检查,评估6组患者的治疗有效率;在手术后第3个月到1年,观察6组患者的妊娠情况。结果:3组预防中度宫腔粘连复发有效率分别为63.64%、77.27%和72.73%;妊娠率分别为63.64%、40.91%和45.45%,差异无统计学意义(P>0.05)。3组预防重度宫腔粘连复发有效率分别为23.81%、61.90%和65.00%;妊娠率分别为4.76%、38.10%和35.00%。重度宫腔粘连COOK球囊支架组、重度宫腔粘连宫腔用交联透明质酸钠凝胶组有效率及妊娠率高于重度宫腔粘连圆形宫内节育器组,差异有统计学意义(P≤0.05)。重度宫腔粘连COOK球囊支架组、重度宫腔粘连宫腔用交联透明质酸钠凝胶组的有效率及妊娠率差异无统计学意义(P>0.05)。结论:重度宫腔粘连患者行宫腔镜下宫腔粘连分离术后留置COOK球囊支架或宫腔用交联透明质酸钠凝胶有利于预防粘连复发,治疗有效率及妊娠率均优于放置圆形宫内节育器。
Objective:To investigate the effectiveness of the intrauterine contraceptive devices,COOK balloon stents,and cross-linked sodium hyaluronate gel in treating readhesions after moderate and severe intrauterine adhesion dissociation.Methods:A total of 128 patients with moderate to severe uterine adhesions,who underwent hysteroscopic separation of uterine adhesions at the Gynecology Inpatient Department of Puning Maternal and Child Health and Family Planning Service Center from January 2014 to January 2019,were selected.The patients were divided into six groups.All patients in the six groups received estradiol valerate therapy after transcervical resection of adhesion to repair the endometrium and underwent follow-up.At the third month after treatment,the recovery of menstruation was observed,and hysteroscopy was performed to evaluate the treatment effectiveness of the six groups.Pregnancy status was observed and followed up in the six groups from the third month to one year after surgery.Results:The effective rates of preventing moderate intrauterine adhesion recurrence were 63.64%,77.27%,and 72.73%.The pregnancy rates were 63.64%,40.91%,and 45.45%.No significant difference was found in the effective rate and pregnancy rate among the three groups(P>0.05).The effective rates of preventing severe intrauterine adhesion recurrence were 23.81%,61.90%and 65.00%.The pregnancy rates were 4.76%,38.10%,and 35.00%.The effective rate and pregnancy rate of the severe intrauterine adhesions COOK balloon stent group and severe intrauterine adhesion intrauterine cross-linked sodium hyaluronate gel group were higher than those of the intrauterine contraceptive device group,the difference was statistically significant(P≤0.05).No significant difference was observed in the effective rate and pregnancy rate between the severe intrauterine adhesions COOK balloon stent group and the self-cross-linked sodium hyaluronate gel group(P>0.05).Conclusion:In patients with severe intrauterine adhesions after transcervical resection of adhesions,the implantation of COOK balloon stent or cross-linked sodium hyaluronate gel into the uterine cavity is beneficial in preventing the recurrence of adhesions.The treatments effectiveness rate and pregnancy rate are better than that of intrauterine contraceptive devices.
作者
林淑玲
LIN Shuing(Department of Gynecology,Puning Maternal and Child Health and Family Planning Service Center,Puning 515300,China)
出处
《汕头大学医学院学报》
2023年第4期224-228,共5页
Journal of Shantou University Medical College
关键词
宫腔镜
宫腔粘连
宫腔粘连复发
对比研究
hysteroscopy
intrauterine adhesions
recurrent uterine adhesions
comparative study
