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目的观察宫腔镜下分离宫腔黏连后3种预防再黏连方法的疗效。方法选择经宫腔镜诊断为宫腔黏连并成功分离黏连者108例,随机分为置环组、置环+人工周期组、几丁糖组,其中置环组为对照组,术后1个月宫腔镜下观察3组宫腔内黏连情况。结果Ⅰ、Ⅱ度黏连的患者,3组的再黏连率分别为10.00%、8.33%、7.69%(P﹥0.05),对Ⅲ度及以上黏连的患者,置环组的宫腔再黏连率为44.00%,高于后两组,且置环组肌性及结缔组织性黏连比例45.45%,高于后两组(P﹤0.05)。结论对于Ⅰ、Ⅱ度黏连的患者3种方法预防再黏连的疗效相同,而Ⅲ度及以上宫腔黏连的患者,术后应用置环+人工周期或几丁糖能显著减少术后宫腔再黏连的发生,较之单纯术后置环有明显的优势。
Objective To observe the curative effect of hysteroscopic three methods of preventing adhesions after intrauterine adhesions. Methods 108 cases diagnosed as uterine adhesions and successfully isolated adhesion by hysteroscopy were randomly divided into three groups: control group, control group, 1 month hysteroscopic observation of intrauterine adhesions in three groups. Results In patients with grade I and II adhesions, the rate of re-adhesion in the three groups was 10.00%, 8.33% and 7.69%, respectively (P> 0.05). In patients with grade III or above adhesions, The adhesion rate was 44.00%, higher than the latter two groups, and the ratio of muscular and connective tissue adhesions in the circumcision group was 45.45%, which was higher than the latter two groups (P <0.05). Conclusions The three methods for preventing adhesions in patients with grade Ⅰ and Ⅱ adhesions have the same effect in preventing adhesions. In patients with degree Ⅲ or more of uterine adhesions, postoperative application of loop + artificial cycle or chitosan can significantly reduce postoperative The occurrence of intrauterine adhesions, compared with simple postoperative ring has obvious advantages.