摘要
目的探讨宫腔镜定期检查预防重度宫腔粘连行粘连分离术后再粘连的效果。方法回顾性分析行宫腔镜下粘连分离术37例重度宫腔粘连患者的临床资料，术后按不同的预防措施分为两组。A组21例，术毕放置球囊尿管3～4d后放置宫内节育器（IUD），并给予雌孕激素建立人工周期。B组16例，处理措施同A组并定期复查宫腔镜。两组患者均于术后3个月复查宫腔镜并取环，随访月经改善情况。再发中重度粘连者为C组，给予B组措施3个月，继续随访月经量改善情况。结果术后3个月复查：B组较A组粘连率明显降低（P〈0．05），月经量明显改善（P〈0．05）。A组宫腔再粘连率为57．14％（12／21）；B组为12．50％（2／16）；其中A组中重度粘连所占比例为42．86％（9／21，中度6例，重度3例），B组为6．25％（1／16，中度1例）。A组月经量改善率为57．14％（12／21）；B组为87．50％（14／16）；术后6个月C组复查2例轻度粘连，2例中度粘连，7例经量明显改善，各组患者未见肝肾功能异常。结论重度宫腔粘连分离术后，在放置球囊尿管、IUD及应用雌激素的基础上加用官腔镜定期检查可有效防止宫腔再粘连发生，促进月经恢复。
Objective To investigate the effect of regular hysteroscopy ting the recurrent adhesion after the separatibn of severe intrauterine adhesion. examination on preven- Methods The clinical data of 37 patients with severe intrauterine adhesion underwent transcervical resection of adhesions （TCRA） were analyzed retrospectively. They were divided into two groups according to different preven- A, and were reviewed by hysteros.copy regularly. All the patients were followed by the examination of menstrual recovery in three months after operation and were reviewed by hysteroscopy at the third month what time the IUD were taken out. The patients who had moderate to severe intrauterine adhesion again were categorized as group C, and were given adhesiotomy again and the same treatment as group B, the conditions of intrauterine adhesion and menstrual recovery were recorded. Results Three months＇ fol- low up showed that the rate of recurrent intrauterine adhesion in group B was significantly lower than that in group A （ P 〈 0.05 ） , and the menstrual quantity in group B was also improved obviously （P 〈 0.05 ）. The rates of recurrent intrauterine adhesion of the two groups were as follows： 57.14% （ 12/21 ） in group A, 12.50% （2/16） in group B. The proportions of recurrent moderate to severe intrauterine adhesion were as follows： 42.86% in group A（9/21, 6 cases of moderate adhesion and 3 cases of severe adhesion） , 6.25% in group B（ 1/16, 1 case of moderate adhesion）. The improvement rates of menstrual quantity were as follows： 57. 14% （ 12/21 ） in group A and with 87.50% （14/16） in group B. Six months after operation, there were 2 cases with mild adhesion and 2 cases with moderate adhesion in group C, 7 cases had improvement of menstrual quantity.No kidney or liver function abnomality has been found in all of the patients. Conclusions After postoperative separation of severe intrauterine adhesion, regular hysteroscopy examination on the basis of putting a balloon urinary catheter and IUD combined with estrogen can effectively prevent the recurrence of adhesion and improve the menstrual recovery.
出处
《中国实用医刊》
2012年第8期16-18,共3页
Chinese Journal of Practical Medicine
关键词
宫腔粘连
宫腔镜
宫腔粘连分离术
戊酸雌二醇
Intrauterine adhesions
Hysteroscopy
Transcervical resection of adhesions
Estradiol valerate
