摘要
目的探讨TCRA术后应用Foley球囊联合人工周期治疗宫腔粘连的临床效果。方法随机选取2019年1月—2020年6月在该院行TCRA术治疗的90例宫腔粘连患者为研究对象,按照随机数表法分为A组、B组、C组,每组30例。A组给予术后宫腔放置Foley球囊,B组给予术后人工周期,C组给予术后宫腔放置Foley球囊联合人工周期治疗。比较3组患者临床疗效、治疗前后月经量及血清ER、TGF-β1和MMP-9水平。随访所有患者1年时间里,记录再粘连和妊娠结局情况。结果治疗后,C组患者月经量(48.87±9.95)g高于A组(40.65±7.72)g、B组(36.03±6.84)g,差异有统计学意义(F=18.530,P<0.05)。C组治疗总有效率(96.7%)显著高于A组(80.0%)、B组(76.7%),差异有统计学意义(χ^(2)=4.043、5.192,P<0.05)。术后3个月,C组患者ER水平均高于A组、B组,TGF-β1水平均低于A组、B组,差异有统计学意义(P<0.05)。术后6个月,C组患者再粘连发生率(13.3%)低于A组(36.7%)、B组(43.3%),差异有统计学意义(χ^(2)=4.356、6.648,P<0.05)。术后12个月,C组患者再粘连发生率(30.0%)低于B组(60.0%),差异有统计学意义(χ^(2)=5.455,P<0.05)。术后1年内,3组患者妊娠率(30.0%、20.0%、36.7%)、自然流产率(10.0%、10.0%、6.7%)比较,差异无统计学意义(P>0.05)。结论TCRA术后给予后宫腔放置Foley球囊联合人工周期治疗可有效提高治疗效果,预防再粘连的发生,其作用机制可能与血清ER、TGF-β1和MMP-9水平改善有关。
Objective To investigate the clinical effect of Foley balloon combined with artificial cycles in the treatment of intrauterine adhesions after TCRA.Methods From January 2019 to June 2020,90 patients with intrauterine adhesions who underwent TCRA treatment in the hospital were randomly selected as the research objects.According to the random number table,they were divided into group A,group B,and group C,with 30 cases in each group.Group A was given a Foley balloon placed in the uterine cavity after surgery,group B was given a postoperative artificial cycle,and group C was given a Foley balloon placed in the uterine cavity combined with artificial cycle treatment.The clinical efficacy,menstrual volume before and after treatment,and serum ER,TGF-β1 and MMP-9 levels were compared among the three groups.All patients were followed up for 1 year,and re-adhesion and pregnancy outcomes were recorded.Results After treatment,the menstrual volume(48.87±9.95)g of group C patients was higher than that of group A(40.65±7.72)g and group B(36.03±6.84)g,the difference was statistically significant(F=18.530,P<0.05).The total effective rate of treatment in group C(96.7%)was significantly higher than that in group A(80.0%)and group B(76.7%),and the difference was statistically significant(χ^(2)=4.043,5.192,P<0.05).Three months after the operation,the ER level of patients in group C was higher than that of groups A and B,and the level of TGF-β1 was lower than that of group A and B,the difference was statistically significant(P<0.05).At 6 months after operation,the incidence of re-adhesion in group C(13.3%)was lower than that in group A(36.7%)and group B(43.3%),and the difference was statistically significant(χ^(2)=4.356,6.648,P<0.05).After 12 months,the incidence of re-adhesion in group C(30.0%)was lower than that in group B(60.0%),and the difference was statistically significant(χ^(2)=5.455,P<0.05).Within 1 year after operation,there was no statistically significant difference in the pregnancy rate(30.0%,20.0%,36.7%)and spon
作者
王博文
梁惠玲
曾碧玲
WANG Bowen;LIANG Huiling;ZENG Biling(Department of Obstetrics and Gynecology,Guangzhou First People's Hospital,Guangzhou,Guangdong Province,510180 China)
出处
《中外医疗》
2022年第6期9-12,21,共5页
China & Foreign Medical Treatment
基金
广东省医学科学技术研究基金项目(B2021246)。
