摘要
目的探讨不同宫腔内装置方法预防宫腔粘连分离术(TCRA)后再粘连的临床疗效。方法回顾性分析2016年8月至2018年8月期间在河南省人民医院治疗中重度宫腔粘连并成功分离98例患者的临床资料,根据术后宫腔内放置的装置不同分成3组,A组放置金属元宫环(IUD)(30例);B组放置宫腔支撑球囊(30例);C组放置金属元宫环+防粘连膜(38例)。对比3组患者术后宫腔恢复情况、术后宫腔粘连评分改善率、临床疗效及月经改善情况。结果对于中重度宫腔粘连患者成功分离宫腔粘连后3组患者治疗前后宫腔粘连评分差值,C组较A、B组均有显著改善(A组:9.50±8.00,B组:11.00±7.00,C组:14.50±9.00;A、C组比较,P<0.001;B、C组比较,P<0.001)。3组治疗前后子宫内膜厚度差值,C组较A、B组均有显著改善[A组:(2.34±1.43)mm,B组:(2.53±1.72)mm,C组:(3.82±3.00)mm;A、C组比较,P=0.003;B、C组比较,P=0.005]。3组治疗后月经量比较,C组较A、B组均有显著改善(A、C组比较,χ^2=8.420,P=0.015;B、C组比较,χ^2=8.678,P=0.013)。术后1、3个月常规行宫腔镜检查,根据2015年中国宫腔粘连分级评分标准再次进行评分,3组间比较差异均有统计学意义(P均<0.01),C组效果最佳。结论TCRA宫腔内放置金属元宫环联合防粘连膜在预防中重度TCRA后再粘连有较好的效果。
Objective To investigate the therapeutic effect of anti-adhesion membrane,intrauterine device and intrauterine balloon stent on intrauterine adhesion.Methods Ninety patients with moderate to severe intrauterine adhesions treated in Henan Provincial People's Hospital from August 2016 to June 2018 were divided into three groups according to the treatment of different intrauterine devices:group A(30 cases)with intrauterine device(IUD),group B(30 cases)with intrauterine balloon stent and group C(38 cases)with metal intrauterine device plus anti-adhesion membrane.Improvement rate of intrauterine adhesion score,clinical efficacy and menstrual improvement of the three groups were compared among these groups.Results For patients with moderate to severe intrauterine adhesions,the difference between the intrauterine adhesion scores before and after treatment was significantly improved in group C compared with groups A and B(group A:9.50±8.00,group B:11.00±7.00,group C:14.50±9.00,comparison of groups A and C:P<0.001,comparison of groups B and C:P<0.001).The difference between endometrial thickness before and after treatment was significantly improved in group C compared with groups A and B[group A:(2.34±1.43)mm,group B:(2.53±1.72)mm,group C:(3.82±3.00)mm,comparison of groups A and C:P=0.003,comparison of groups B and C:P=0.005].The menstrual volume after treatment was significantly improved in group C compared with groups A and B(comparison of groups A and C,χ^2=8.420,P=0.015;comparison of groups B and C,χ^2=8.678,P=0.013).Hysteroscopy was routinely performed at 1 and 3 months after surgery,and re-scoring was performed according to the 2015 Chinese uterine adhesion rating scale.The differences among the three groups were statistically significant(P<0.01).Conclusion Operation with metal intrauterine device plus anti-adhesion membrane has a good therapeutic effect on moderate and severe intrauterine adhesions.
作者
陈贵芹
李娜
王显
李辉
董黎
史素娥
王素芳
金靖
Chen Guiqin;Li Na;Wang Xian;Li Hui;Dong Li;Shisue null;Wang Sufang;Jin Jing(Department of Gynecology,Henan Provincial People's Hospital,Zhengzhou University People's Hospital,Henan University People's Hospital,Zhengzhou 450000,China)
出处
《中华生殖与避孕杂志》
CAS
CSCD
北大核心
2020年第5期388-393,共6页
Chinese Journal of Reproduction and Contraception
基金
河南省卫生厅科研基金(201702229)。
