摘要
宫腔粘连又称Asherman综合征,常表现为月经量减少,甚至闭经,伴或不伴周期性腹痛。宫腔粘连常引起不孕,即使妊娠发生胚胎停育、胎盘粘连、植入等风险也增加。其治疗方案为手术治疗联合术后辅助治疗。宫腔镜宫腔粘连分离术是宫腔粘连的标准手术方式,其是在宫腔镜直视下分离宫腔粘连,切除粘连形成的瘢痕,恢复宫腔解剖结构,术中需注意充分保护正常内膜组织。术后使用药物、宫内置入支撑组织、干细胞治疗等方法可达到改善月经情况、促进生育、预防再次粘连的目的。未来,冻干羊膜和干细胞治疗有望成为新研究方向。
Intrauterine adhesion,also known as Asherman syndrome,often shows a decrease in menstrual flow,even amenorrhea ,with or without periodic abdominal pain.Intrauterine adhesion often causes infertility,and the risk of embryo suspension,placenta adhesion,placenta implantation increases even when pregnancy happens.The treatment plan is surgical treatment combined with postoperative adjuvant treatment.Hysteroscope transcervical resection of adhesion is the standard operation for intrauterine adhesion.It is to separate the intrauterine adhesions under hysteroscopy,resect the scars formed by adhesions,restore the anatomical structure of the uterine cavity,and fully protect the normal endometrial tissues during the operation.Postoperative use of drugs,intrauterine implantation of supporting tissue and stem cell therapy can improve menstruation,promote fertility and prevent re-adhesion.In the future,freeze-dried amniotic membrane and stem cell therapy are expected to become new research directions.
作者
林立君
许良智
陈慧
LIN Lijun;XU Liangzhi;CHEN Hui(Department of Gynecology and Obstetrics,West China second Hospital, Sichuan University,Chengdu 610041;Key Laboratory of birth defects and related Maternal and Child Diseases Ministry of Education,West China second Hospital of Sichuan University,Chengdu 610041)
出处
《医学综述》
2019年第5期922-927,933,共7页
Medical Recapitulate
基金
国家自然科学基金(81671421)
四川大学华西第二医院临床科研基金(KL005)
四川省科学技术厅应用基础研究计划项目(2018JY0336)
关键词
宫腔粘连
宫腔镜
宫腔粘连分离术
Intrauterine adhesion
Hysteroscope
Transcervical resection of adhesion
