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中重度宫腔粘连分离术后预防宫腔再粘连的临床效果观察 被引量:35

Clinical effect of prevention of re-adhesion after trans-cervical resection of adhesions
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摘要 目的:探讨中重度宫腔粘连分离术后预防宫腔再粘连的临床效果。方法:回顾性分析2013年1月至2014年6月在武汉大学人民医院就诊的119例经宫腔镜检查确诊为中重度宫腔粘连并行 TCRA 术患者的临床资料。术后宫腔放置 Foley 球囊导尿管+宫内节育器为 A 组,宫腔放置 Foley 球囊导尿管+宫内节育器+可吸收医用膜为 B 组,术后均使用人工周期。比较患者的术后月经改善、宫腔及妊娠情况。结果:中度宫腔粘连患者中,B 组的治愈率高于 A 组(57.7% vs 31.0%,P =0.047),宫腔再粘连率低于 A 组(15.4% vs 44.8%,P =0.018);A、B 组的妊娠率分别为40%、60%,差异无统计学意义(P=0.37)。重度宫腔粘连患者中,B 组的治愈率高于 A 组(43.8% vs 18.8%,P =0.031),宫腔再粘连率低于 A 组(15.6% vs 46.9%,P =0.007);A、B 组的妊娠率分别为11.1%和33.3%,差异无统计学意义(P =0.257)。结论:中重度宫腔粘连分离术后联合使用 Foley球囊导尿管+宫内节育器+可吸收医用膜治疗效果优于 Foley 球囊导尿管+宫内节育器组。 Objective:To investigate the clinical effect of preventing the recurrence of adhesion after hysteroscopic resection for moderate or severe intrauterine adhesion. Methods:Clinical data of 119 cases which diagnosed moderate or severe intrauterine adhesion were col-lected in the Renmin Hospital of Wuhan University from Jan. 2013 to June 2014. After trans-cervical resection of adhesions ( TCRA),patients were divided into two groups:Group A in-stalled Foley balloon catheter and intrauterine device,Group B installed Foley balloon catheter, intrauterine device (IUD) and biomembrane. Artificial cycle was administered after surgery. The situation of intrauterine cavity,menstrual improvement,and pregnancy were observed after the operation. Results:Moderate intrauterine adhesions group:the cure rate of group B were sig-nificantly higher than group A (57. 7% vs 31. 0% ,P =0. 047),the recurrence rate of group B were significantly lower than group A(44. 8% vs 15. 4% ,P =0. 018). There were no significant differences in pregnant rate between group A(40% ) and B(60% )(P = 0. 37). Severe intrau-terine adhesions group:the cure rate of group B were significantly higher than that of group A(43. 8% vs 18. 8% ),the recurrence rate of group B was significantly lower than that of group A(46. 9% vs 15. 6% ,P = 0. 018). There were no significant differences in pregnant rate be-tween group A(11. 1% ) and B (33. 3% )(P =0. 257). Conclusion:The combination of Foley balloon catheter,intrauterine device and biomembrane after hysteroscopic resection for moderate or intensive IUA is a better method than the combination of Foley balloon catheter,intrauterine device.
作者 黄玥 张蔚 王勇 易跃雄 Huang Yue, Zhang Wei, Wang Yong, et al. (Department of Gynecology, Renmin Hospital of Wuhan University, Wuhan 430060)
出处 《现代妇产科进展》 CSCD 北大核心 2015年第8期583-585,共3页 Current Advances In Obstetrics and Gynecology
关键词 宫腔粘连 医用膜 宫内节育器 宫腔镜下宫腔粘连分离术 Intrauterine adhesion Biomembrane Intrauterine device Trans-cervical resection of adhesions
作者简介 黄玥(1991-),女,武汉大学人民医院硕士研究生。主要研究方向:微创手术。 通讯作者 Email:zw6676@163.com
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参考文献13

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