摘要
目的探讨宫腔镜下宫腔粘连分离术后医用几丁糖联合大剂量雌激素预防宫腔再粘连的临床效果。方法2008年3月～2011年6月80例宫腔粘连在我院行宫腔镜下宫腔粘连切除术,根据术后防粘连方法的不同分为研究组及对照组:研究组41例,术毕予医用几丁糖2.5 ml,术后口服戊酸雌二醇片3 mg,Q12 h,共21 d;对照组39例,术毕置放宫内节育器,术后口服戊酸雌二醇片1 mg,QD,共21 d。结果研究组宫腔镜手术后宫腔再粘连3例,此3例术前均为重度粘连,分离2次后均成功。对照组宫腔镜手术后宫腔再粘连9例,其中3例术前为中度粘连,6例为重度粘连,3例分离2次成功,余6例随访3个月B超示子宫内膜菲薄(<5 mm),回声不连续。研究组再粘连率7.3%(3/41)明显低于对照组23.1%(9/39)(χ2=3.894,P=0.048)。结论宫腔粘连术后医用几丁糖联合大剂量雌激素能有效预防再粘连。
Objective To study the effect of medical chitosan and estrogen in a large dose for preventing recurrent adhesion after transcervical resection of intrauterine adhesions. Methods Totally 80 patients were divided into two groups： study group （41 patients） received medical chitosan 2.5 ml and estradiol valerate 3 mg, once per 12 hours for 21 days; control group （39 patients） recieved IUD and estradiol valerate 1 mg, once a day for 21 days. Results In the study group, three patients developed recurrent intrauterine adhesion, all of the eases had severe adhesion before the surgery, and they were cured after receiving separation for twice. In the control group, 9 patients developed recurrent adhesion, 3 of them had moderate adhesion before the surgery, and the other 6 were severe cases;3 eases were cured after two procedures of separation; 6 of the patients were followed up for 3 months with ultrasonography, which showed thin uterine wall （ 〈 5 mm） and discontinuous echos. The rate of recurrent intrauterine adhesion recurrence rate was 7.3% （3/41） in the study group, which was significantly lower than that in the control group [ 23.1% （9/39） , X2 = 3. 894, P = 0. 048 ] Conclusions Medical ehitosan and large-dose estrogen after transcervical resection of intrauterine adhesions is an effective method for preventing adhesion recurrence.
出处
《中国微创外科杂志》
CSCD
2011年第12期1114-1115,1120,共3页
Chinese Journal of Minimally Invasive Surgery
关键词
医用几丁糖
雌激素
宫腔粘连
Medical chitosan
Estrogen
Intrauterine cavity
