论文部分内容阅读
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(P<0.05)。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(P<0.05)。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。
Objective To investigate the clinical effects of two kinds of uterine barrier for the treatment of moderate-severe intrauterine adhesion (IUA) undergoing hysteroscopic transcervical resection of adhesions (TCRA). Methods From January 2016 to June 2016, 52 cases of moderate-severe intrauterine adhesions treated in Hubei MCH hospital were divided into two groups according to the method of constructing the uterine barrier after surgery. The observation group: Foley balloon + self-crosslinked sodium hyaluronate gel was placed in the uterine cavity of the operation group, the balloon was removed one day after the operation, hysteroscopy was performed one week later and self-crosslinked gel was injected again. The control group: Placed Foley balloon + ordinary medical sodium hyaluronate gel, 1 week after the removal of the balloon, hysteroscopy, IUD insertion and ordinary sodium hyaluronate gel. All patients underwent artificial cycle treatment. The AFS scores of the intrauterine adhesions and the effective rate of the treatment and the rate of intrauterine re-adhesion were observed after the operation in March. Results At 3 months after operation, the scores of AFS, adhesion area, type of adhesion, and individual status of menstrual status were significantly decreased in both groups. The differences were statistically significant (P <0.05). The AFS score, menstrual status score and re-adhesion rate of the observation group were lower than those of the control group, and the treatment effective rate was higher than that of the control group, the difference was statistically significant (P <0.05). Conclusion The application of Foley balloon + self-crosslinking sodium hyaluronate gel as the uterine barrier after TCRA is an effective method to improve the curative effect of IUA.