摘要
目的探讨宫腔镜定期检查及大剂量戊酸雌二醇预防重度宫腔粘连分离术后再粘连的效果。方法将97例重度宫腔粘连患者按随机数字表法分为A、B、C组，均于月经干净后3～7d行宫腔粘连切除术治疗，然后A组（34例）放置节育环，术后第2天口服戊酸雌二醇1mg/次，3次／d，连用3个月；B组放置节育环，术后第2天口服戊酸雌二醇3mg／次，3次/d，连用3个月；C组在B组基础上每个月进行宫腔镜复查。治疗后行宫腔镜和B超检查，记录子宫内膜厚度、疗效及宫腔再粘连发生情况。结果B组和C组治疗后子宫内膜厚度明显大于A组[（0．83±0．23）和（0．99±0．28）cm比（0．54±0．18）cm]，C组明显大于B组，差异均有统计学意义（P〈0．05）。B组和C组有效率明显高于A组[75．00％（24／32）和90．32％（28／31）比61．76％（21／34）]，C组明显高于B组，差异均有统计学意义（P〈0．05）。B组和C组宫腔再粘连发生率明显低于A组[21．88％（7，32）和9．68％（3／31）比38．23％（13／34）]，C组明显低于B组，差异均有统计学意义（P〈0．05）。结论应用宫腔镜定期检查及大剂量戊酸雌二醇能显著减少重度宫腔粘连术后再粘连发生，较单纯放置节育环、常规雌激素辅助节育环治疗均有明显的优势。
Objective To investigate the prevention of re-adhesion after high dose estradiol valerate and hysteroscopy regular inspection after separation of severe intrauterine adhesions. Methods A total of 97 severe intrauterine adhesions patients after transcervical resection of adhesions were divided into group A, B, C： group A placed intrauterine device and oral intook progynova 1 mg/d after 2 days of surgery, 3 times/d, for 3 months; group B placed intrauterine device and oral intook progynova 3 mg/d after 2 days of surgery, 3 times/d,for 3 months; group C with the same treatment as group B with further hysteroscopy regular inspection every month. Regular follow-up data were collected in the following 3 months to compare endometrial thickness,re-adhesion occurrence and treatment effect in different groups. Results After 3 months of treatment, endometrial thickness of group B and group C was higher than that in group A [ （0.83 ± 0.23 ）, （0.99 ± 0.28） cm vs. （0.54 ± 0.18） cm ], group C was higher than group B, and there were significant differences （P 〈 0.05 ）. The effective rate in group B and group C was higher than that in group A [ 75.00% （24/32）, 90.32% （28/31 ） vs. 61.76% （21/34 ） ], group C was higher than group B, and there were significant differences （P 〈 0.05 ）. The occurrence rate of re-adhesion in group B and group C was lower than that in group A [21.88%（7/32）, 9.68%（3/31）vs. 38.23%（13/34）] ,group C was higher than group B,and there were significant differences （P 〈 0.05）. Conclusion The prevention of re-adhesion after high dose estradiol valerate and hysteroscopy regular inspection is effective and superior.
出处
《中国医师进修杂志》
2014年第18期41-43,共3页
Chinese Journal of Postgraduates of Medicine
关键词
宫腔镜
宫腔粘连
戊酸雌二醇
Hysteroscopes
Intrauterine adhesion
Estradiol valerate
