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目的探讨重度宫腔粘连(intrauterine adhesion,IUA)患者于宫腔镜宫腔粘连分离术(transcervical resection of adhesions,TCRA)前应用戊酸雌二醇预防宫腔再粘连的疗效。方法选取因重度IUA行分离术的96例患者,按术前是否用药分为预处理组46例:于手术前3个月连续口服戊酸雌二醇(补佳乐)2 mg,1次/d,最后10 d加用黄体酮0.1 g,2次/d,出血撤退后手术;术后连续口服21 d戊酸雌二醇1 mg,3次/d,最后5 d加用黄体酮胶丸0.1 g,2次/d口服,人工周期治疗。对照组50例:术前不予处理,术后治疗与预处理组一致。随访两组术后月经改善情况、宫腔再粘连情况及妊娠情况。结果两组宫腔再粘连率比较差异有统计学意义(P<0.05),月经改善率及妊娠率比较差异无统计学意义(P>0.05)。结论重度IUA患者TCRA术前应用戊酸雌二醇预处理对预防宫腔再粘连有一定作用。
Objective To investigate the effect of estradiol valerate on prevention of intrauterine adhesions in patients with severe intrauterine adhesion (IUA) before transcervical resection of adhesions (TCRA). Methods A total of 96 patients with severe IUA segregation were divided into pretreatment group (n = 46) according to preoperative medication: 2 mg estradiol valerate d, the last 10 d plus progesterone 0.1 g, 2 times / d, bleeding after surgery; continuous oral 21 d estradiol valerate 1 mg, 3 times / d, the last 5 d plus progesterone capsules 0.1 g, 2 times / d oral, artificial cycle treatment. Control group of 50 patients: no preoperative treatment, postoperative treatment and pretreatment group. Follow-up postoperative menstrual improvement, intrauterine adhesions and pregnancy status. Results There was significant difference in the rate of intrauterine reocclusion between the two groups (P <0.05). There was no significant difference in the rate of improvement of menstruation and pregnancy (P> 0.05). Conclusion Pretreatment with estradiol valerate prior to TCRA in patients with severe IUA may play a role in prevention of intrauterine re-adhesion.