[1]黄燕明,杜欣,王燕,等.两种宫腔屏障用于宫腔粘连术后的临床效果观察[J].第三军医大学学报,2017,39(13):1396-1399.
 HUANG Yanming,DU Xin,WANG Yan,et al.Clinical effect of 2 kinds of barriers for intrauterine adhesion by hysteroscopic surgery[J].J Third Mil Med Univ,2017,39(13):1396-1399.
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两种宫腔屏障用于宫腔粘连术后的临床效果观察(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
39卷
期数:
2017年第13期
页码:
1396-1399
栏目:
临床医学
出版日期:
2017-07-15

文章信息/Info

Title:
Clinical effect of 2 kinds of barriers for intrauterine adhesion by hysteroscopic surgery
作者:
黄燕明杜欣王燕阳艳金晶姚冬梅刘玉兰舒茵
湖北省妇幼保健院妇科
Author(s):
HUANG Yanming DU Xin WANG Yan YANG Yan JIN Jing YAO Dongmei LIU Yulan SHU Yin

Department of Gynecology, Hubei Provincial Maternal and Children Hospital, Wuhan, Hubei Province, 430070, China

关键词:
宫腔粘连宫腔屏障透明质酸宫腔镜检查
Keywords:
intrauterine adhesion intrauterine barrier sodium hyaluronate gel hysteroscopic examination
分类号:
R197.39; R711.74; R713.4
文献标志码:
A
摘要:

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。

Abstract:

Objective        To investigate the clinical effect of 2 kinds of intrauterine barriers for the patients with moderate to severe intrauterine adhesion (IUA) after hysteroscopic transcervical resection of adhesions (TCRA). Methods       A total of 52 patients with moderate to severe IUA undergoing TCRA via hysteroscopy in our hospital from January 2016 to June 2016 were enrolled in the study. They were randomly divided into 2 groups according to various intrauterine barriers. In the observation group, Foley balloon catheter and crosslinked sodium hyaluronate gel were introduced into uterine after operation, and then the catheter was pulled out on the next day. Second-look hysteroscopic examination was performed at a week later and auto-crosslinked sodium hyaluronate gel was given to uterine again at the same time. In the control group, the Foley balloon catheter and common medical sodium hyaluronate gel were introduced into the uterine after operation. Second-look hysteroscopy was also performed and the catheter was also pulled out at a week later, meanwhile, an intrauterine device was given to uterine. Artificial cycle treatment and monthly second-look hysteroscopy was performed for all patients. At 3 months postoperatively, all cases were assessed for the shape of uterus cavity and menstruation, the severity of IUA by American Fertility Society (AFS) classification, treatment efficacy and recurrence of IUA. Results       The total AFS score, scores of adhesive range and type, and menstrual pattern in 3 months were significantly lower than before operation in both groups (P<0.05). The total AFS score, menstrual pattern and rate of readhesion were significantly lower in the observation group than the control group, and the effective rate was significantly higher (P<0.05). Conclusion       Foley balloon catheter and auto-crosslinked sodium hyaluronate gel as intrauterine barrier after TCRA is an optional approach for IUA treatment.

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更新日期/Last Update: 2017-07-14