摘要
【目的】探讨宫腔粘连（IuA）分离术（TCRA）后官腔留置节育器联合不同剂量雌激素对宫腔再粘连、月经恢复及妊娠率的影响。【方法】回顾性分析2014年1月至2017年1月在本院诊治的60例IUA患者的临床资料。所有患者均于月经后3～7d行腹腔镜监护下宫腔镜IUA分离术，术后宫腔留置“0”形金属节育器和口服雌激素。根据雌激素使用剂量的不同分为低剂量组（3mg／d）25例，中剂量组（6mg／d）19例，高剂量组（9mg／d）16例。术后随访3个月，检查子宫内膜厚度变化、宫腔再粘连及月经恢复情况；按照美国生育协会（AFS）要求进行IUA评分；对于有生育要求的患者关注术后1年内妊娠情况。【结果】低剂量组宫腔再粘连发生率小于中、高剂量组，月经恢复正常比率大于中、高剂量组，差异均具有统计学意义（P〈0．05）。治疗后，低剂量组AFS评分较中、高剂量组下降更明显，差异有统计学意义（P〈0．05）。治疗后，低剂量组子宫内膜厚度较中、高剂量组增加更明显，差异有统计学意义（P〈0．05）。三组患者术后1年内妊娠率分别为54．5％（6／11）、50．0％（8／16）、55．6％（5／9），比较差异无统计学意义（P〉0．05）。【结论】宫腔留置节育器联合低剂量雌激素有利于IUA分离术患者的恢复，可降低宫腔再粘连，改善月经恢复，且对术后妊娠率无明显影响。
[Objective]To investigate the effects of intrauterine device combined with different doses of estrogen on intrauterine adhesion （IUA）, menstrual recovery and pregnancy rate after laparoscopic intrauterine adhesions separation by trans-cervical resection of adhesion （TCRA）.EMethodslThe clinical data of 60 patients with intrauterine adhesions in our hospital from January 2014 to January 2017 were analyzed retrospectively. All patients underwent trans-cervical resec- tion of adhesion at 3-7 days after menstruation, and were given water sac combined with estrogen after operation. Ac- cording to the different doses of estrogen received, patients were divided into the low-dose group （3 mg/d） with 25 cases, the middle-dose group （6mg/d） with 19 cases, and the high-dose group （9mg/d） with 16 cases. Patients were followed up with three months after operation, and changes in endometrial thickness, incidence of intrauterine adhesions and recov- ery of menstruation were examined. Based on the requirements of the American Fertility Association （AFS）, the intrau- terine adhesions score was determined. For patients who had fertility requirements, conditions for pregnancy within 1 year after operation were noted. [Results]The incidence of intrauterine re-adhesions in the low-dose group was less than that in the middle-and high-dose groups, and the percentile of menstruation recovery was higher than that in the middle-and high- groups. The differences were statistically significant （ P〈0.05）. After treatment, the AFS score in the low-dose group decreased more obviously than that in the middle- and high-dose groups, and the difference was statistically significant （ P〉0.05）. The thickness of the endometrium after treatment in the low-dose group increased more obviously than that in the middle- and high-dose groups and the difference was statistically significant （ P〈0.05）. The pregnancy rates within 1 year after operation in the three groups were 54.5% （6/11）, 50% （8/16）, and 55.6%
作者
叶凤如
黄玉玲
彭海燕
王武
李婵玉
YE Feng-ru;HUANG Yu-ling;PENG Hai-yan(Department of Obstetrics and Gynecology, Dalang Hospital of Dongguan, Dongguan, Guangdong 52377)
出处
《医学临床研究》
CAS
2018年第6期1086-1088,共3页
Journal of Clinical Research
