国际生殖健康/计划生育 ›› 2017, Vol. 36 ›› Issue (1): 22-25.

• 论著 • 上一篇    下一篇

防粘连膜和球囊治疗重度宫腔粘连的疗效比较

易灵   

  1. 广东省清远市妇幼保健院
  • 收稿日期:2016-11-25 修回日期:2016-12-06 出版日期:2017-01-15 发布日期:2017-03-29
  • 通讯作者: 易灵 E-mail:40283314@qq.com

  • Received:2016-11-25 Revised:2016-12-06 Published:2017-01-15 Online:2017-03-29

摘要: 目的:比较治疗重度宫腔粘连时,放置Interceed防粘连膜加宫内节育器与Foley球囊加几丁糖(48小时后放置宫内节育器)两种治疗方法,对宫腔形态及月经量改善的效果。方法:对2012年9月至2015年11月在清远市妇幼保健院通过宫腔镜检查确诊的84例重度宫腔粘连患者随机分为两组,A组:行宫腔镜粘连分离后,放置Interceed加宫内节育器,B组:在宫腔粘连分离后宫腔内注入几丁糖,留置球囊2天后取出并放置宫内节育器。两组均术后第2天开始口服雌孕激素3个周期,4个月后再次行宫腔镜检查加取环术。结果:A组患者治愈23例,好转15例,无效3例,B组患者治愈6例,好转30例,无效7例,两组比较发现Interceed组治愈率较高(P<0.05)。患者术后月经量较治疗前增多,两组比较发现Interceed组治疗后月经增加量更多(P<0.05)。结论:宫腔粘连分离术后联合放置Interceed防粘连膜及宫内节育器,术后给予雌孕激素周期治疗,能有效改善重度宫腔粘连患者宫腔形态及恢复月经,比Foley球囊加几丁糖的治疗方式能更有效地预防宫腔再次粘连。

Abstract: Objective: To compare two kinds of treatment methods of severe intrauterine adhesions,we placed Interceed anti adhesion membrane with intrauterine device (IUD) or Foley balloon and chitosan ( placing IUD after 48 hours) to observe the effect of improved uterine cavity shape and menstrual volume.Methods: 84 cases are diagnosed of severe intrauterine adhesions by hysteroscopy in Maternal and child health care hospital of Qingyuan from September 2012 to November 2015.They were randomly divided into two groups. Group A: Hysteroscopy adhesiolysis, placed Interceed with IUD. Group B: Separation of adhesion, intrauterine injected of Chitosan, indwelled Foley balloon( removed and placed IUD 2 days later). Two groups were giving oral estrogen and progesterone 3 cycles on the second day, making a hysteroscopy and taking the ring out 4 months later.Results:In group A, 23 cases were cured, 15 cases were improved, 3 cases were ineffective. In group B, 6 cases were cured, 30 cases improved, 7 cases were ineffective.The cure rate of group A was higher than group B(P<0.05). The amount of menstruation after operation was increased.Comparison of the two groups found that menstruation of group A increased more after the treatment(P<0.05).Conclusions: Giving estrogen and progesterone after resection of intrauterine adhesions,placing Interceed anti adhesion membrane and IUD can effectively improve uterine cavity shape and menstrual volume in severe intrauterine adhesions. Interceed anti adhesion membrane is more effectively than Foley balloon and chitosan treatment in preventing re adhesion of uterine cavity.