摘要
目的:观察序贯口服戊酸雌二醇、地屈孕酮联合宫腔球囊用于宫腔粘连(IUA)分离术后的临床效果。方法:将本院2021年1月-2023年12月收治的104例IUA患者为研究对象,按照随机数字表法均分观察组和对照组,各52例。对照组采用戊酸雌二醇联合宫腔球囊治疗;观察组采用序贯口服戊酸雌二醇、地屈孕酮治疗联合宫腔球囊治疗。随访1年观察两组IUA复发及妊娠情况。结果:治疗3个月后,观察组轻度粘连2例(3.8%);对照组轻度粘连4例(5.6%),中度粘连1例(1.9%),差异无统计学意义(P>0.05)。治疗1、3个月及治疗后12个月,观察组的子宫内膜厚度分别为(5.22±0.44)mm、(6.84±0.57)mm、(7.73±0.79)mm,对照组的子宫内膜厚度分别为(4.87±0.48)mm、(6.17±0.52)mm、(6.87±0.73)mm,差异有统计学意义(P<0.05)。观察组月经恢复时间为(2.08±0.69)月,短于对照组的(2.73±0.97)月(P<0.05)。治疗3个月后观察组月经量评分(62.37±13.26)分,高于对照组的(54.73±10.14)分(P<0.05)。观察组发生头痛、乳房胀痛、胃肠道反应等不良反应7例(13.5%),对照组5例(9.6%),两组无统计学差异(P>0.05)。观察组治疗后12个月,妊娠24例(46.2%)、自然流产5例(9.6%),IUA复发2例(3.8%);对照组妊娠16例(30.8%)、自然流产3例(5.8%),IUA复发6例(11.5%),两组无统计学差异(P>0.05)。结论:序贯口服戊酸雌二醇、地屈孕酮联合宫腔球囊用于IUA分离术后,较戊酸雌二醇联合宫腔球囊治疗,在子宫内膜厚度、月经恢复时间及经量方面更具优势。
Objective:To observe the clinical effect of estradiol valerate sequential dydrogesterone combined with uterine balloon for patients after intrauterine adhesion(IUA)separation.Methods:104 patients with IUA who had accepted IUA separation surgery in the hospital from January 2021 to December 2023 were selected as research subjects.According to the random number table method,these patients were divided into observation group and control group.with 52 cases in each group.The patients in both groups received the uterine cook balloon placement,and the patients in the control group were treated with estradiol valerate,while the patients in the observation group were given estradiol valerate sequential dydrogesterone.The recurrence of IUA and the pregnancy status of the patients in the two groups were observed after 1 year of follow-up.Results:After 3 months of treatment,there were 2(3.8%)cases with the mild adhesion in the observation group,and there were 4(5.6%)cases with the mild adhesion and 1(1.9%)case with the moderate adhesion in the control group,and the difference of which had no statistically significant(P>0.05).The endometrial thickness of the patients in the observation group at 1 month,at 3 months or at 12 months after treatment(5.22±0.44 mm,6.84±0.57 mm or 7.73±0.79 mm)was significantly different from that(4.87±0.48 mm,6.17±0.52 mm or 6.87±0.73 mm)of the patients in the control group.The menstrual recovery time(2.08±0.69 months)of the patients in the observation group was significantly shorter than that(2.73±0.97 months)of the patients in the control group(P<0.05).After 3 months of treatment,the menstrual volume score(62.37±13.26 points)of the patients in the observation group was significantly higher than that(54.73±10.14 points)of the patients in the control group(P<0.05).There were 7(13.5%)patients with the adverse reactions,such as headache,breast pain and gastrointestinal reactions,in the observation group,and 5(9.6%)patients with the adverse reactions in the control group,and which of the patients had statistically significant difference between the two groups(P>0.05).There were 24(46.2%)patients with pregnancy,5(9.6%)patients with spontaneous abortion and 2(3.8%)patients with IUA recurrence within 12 months after treatment in the observation group,and there were 16(30.8%)patients with pregnancy,3(5.8%)patients with spontaneous abortion and 6(11.5%)patients with IUA recurrence within 12 months after treatment in the control group,and which of the patients had statistically significant difference between the two groups(P>0.05).Conclusion:Estradiol valerate sequential dydrogesterone combined with uterine balloon for the patients after IUA separation is superior to estradiol valerate sequential dydrogesterone tablet combined with uterine balloon for the patients in terms of the endometrial thickness,the menstrual recovery time and the menstrual improvement of the patients.
作者
徐丽群
熊文雯
陈文芬
XU Liqun;XIONG Wenwen;CHEN Wenfen(Guangdong Maternal and Child Health Care Hospital,Guangdong Province,510010)
出处
《中国计划生育学杂志》
2025年第6期1271-1275,共5页
Chinese Journal of Family Planning
关键词
宫腔粘连
戊酸雌二醇
地屈孕酮片
预防复发
Intrauterine adhesion
Estradiol valerate
Dydrogesterone tablet
Preventing recurrence
