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目的:分析评价宫腔镜下微型剪刀分离复发宫腔粘连的临床疗效。方法:选取宫腔镜电切术后1月复查发现再发宫腔粘连的患者65例,其中40例轻度粘连、25例重度粘连。患者均在门诊行宫腔镜下微型剪刀分离,术毕宫腔注入透明质酸钠凝胶,继续口服戊酸雌二醇周期治疗。术后2~3月复查宫腔镜同时再次分离粘连,进行疗效评价。术后3月期间观察子宫内膜厚度。结果:术后3月,轻度和重度宫腔粘连患者的总有效率分别为92.5%和84%。轻度粘连组术后第2月与第3月的有效率比较,差异有统计学意义(P<0.05);中度粘连组比较,差异亦有统计学意义(P<0.05)。术后3月,两组患者的子宫内膜厚度均增加,两组比较差异有统计学意义(P<0.05);且每组的组间不同时间段内膜厚度比较,差异也有统计学意义(P<0.05)。结论:重复宫腔镜下微型剪刀分离宫腔复发粘连可作为宫腔镜电切分离粘连术后的辅助手段,提高治疗效果。
Objective: To evaluate the clinical effect of hysteroscopic mini scissors in the separation of recurrent uterine adhesions. Methods: A total of 65 patients with recurrent uterine adhesions were retrospectively reviewed in January after hysteroscopic resection. Among them, 40 were mildly adhesive and 25 were severe. Patients were in the clinic hysteroscopic mini scissors separation, intrauterine uterine injection of sodium hyaluronate gel, oral administration of estradiol continue oral cycle treatment. Hysteroscopy 2 to 3 months after the re-separation of adhesions again, the efficacy evaluation. Endometrial thickness was observed during the third month after surgery. Results: The total effective rates of patients with mild or severe intrauterine adhesions were 92.5% and 84% respectively after 3 months. There was significant difference (P <0.05) between the effective rate of the 2nd month and the 3rd month in the mild adhesion group, and the difference was also statistically significant in the moderate adhesion group (P <0.05). After 3 months, the thickness of endometrium of both groups increased, the difference between the two groups was statistically significant (P <0.05); and there was significant difference in the thickness of the film between different groups in each group P <0.05). Conclusion: Hysteroscopic mini scissors separation of intrauterine recurrent adhesions can be used as a hysteroscopic resection of adhesions after the auxiliary means to improve the therapeutic effect.