摘要
目的观察宫腔内注射交联透明质酸钠凝胶加用口服阿司匹林用于预防宫腔镜下宫腔粘连分离(TCRA)术后复发的疗效,为临床应用提供依据。方法选择2021年2月至2021年9月期间在潍坊医学院生殖医院确诊为中、重度宫腔粘连的患者67例,随机分配至TCRA术后不同辅助治疗方案组:对照组(术后宫腔注入交联透明质酸钠凝胶联合雌孕激素治疗,33例)、研究组(在对照组基础上加用阿司匹林治疗,34例)。比较两种治疗方案后的患者恢复情况及治疗期间不良反应发生情况。结果经相应治疗一个周期后,研究组患者宫腔粘连的治愈率(67.6%vs.42.4%)及宫腔深度[(7.42±0.62)cm vs.(7.04±0.75)cm]均显著优于对照组(P<0.05),但两组患者间宫腔粘连治疗的总有效率无显著差异(94.1%vs.84.8%,P>0.05)。TCRA术后观察两个月经周期,研究组患者月经治愈率(64.7%vs.39.4%)及经期天数均显著优于对照组(P<0.05),但月经治疗总有效率与对照组相比无显著差异(94.1%vs.87.9%,P>0.05)。研究组患者治疗一个周期后子宫内膜厚度改善情况显著优于对照组[(6.26±1.11)mm vs.(5.64±1.11)mm,P<0.05]。两组患者间治疗过程中不良反应发生情况(腹痛、发热、不规则阴道流血)均无显著差异(P>0.05)。结论宫腔注射交联透明质酸钠凝胶联合口服阿司匹林预防TCRA术后再粘连的疗效显著,能较好修复并维持宫腔形态、改善月经情况、促进内膜生长,且安全可靠,值得后续临床应用推广。
Objective:To observe the efficacy of cross-linked sodium hyaluronate gel combined with aspirin to prevent recurrence of intrauterine adhesions after hysteroscopic transcervical resection of adhesions(TCRA).Methods:Sixty-seven patients diagnosed moderate to severe degrees of intrauterine adhesions(IUA)in Assisted Reproductive Hospital of Weifang Medical University from Feb.2021 to Sep.2021 were selected as subjects.Patients were randomly divided into control group and study group based on different treatments.Thirty-three patients in control group were injected with cross-linked sodium hyaluronate gel combined with estrogen and progesterone treatment after TCRA,and 34 patients in study groups were treated with additional aspirin on the basis treatment of the control group.The efficacy after treatment and the occurrence of adverse reactions during treatment were compared between the two groups.Results:After one cycle of treatment,the cure rate of intrauterine adhesion(67.6%vs.42.4%)and the improvement of uterine cavity depth[(7.42±0.62)cm vs.(7.04±0.75)cm]in the study group were significantly better than those in the control group(P<0.05),but there was no significant difference in the total effective rate of intrauterine adhesion between the two groups(94.1%vs.84.8%,P>0.05).Two menstrual cycles were observed after TCRA,the cure rate of menstruation recovery(64.7%vs.39.4%)and menstrual days in the study group were significantly better than those in the control group(P<0.05),but there was no significant difference in the total effective rate of menstruation recovery between the two groups(94.1%vs.87.9%,P>0.05).After one cycle of treatment,the improvement of endometrial thickness in the study group was significantly thicker than that in the control group[(6.26±1.11)mm vs.(5.64±1.11)mm,P<0.05].There were no significant differences in the incidence of adverse reactions,including abdominal pain,fever,and irregular vaginal bleeding during treatment between the two groups(P>0.05).Conclusions:Cross-linked sodium hyaluro
作者
桑田
翟超
李光璨
张晓轩
裴景亮
任春娥
SANG Tian;ZHAI Chao;LI Guang-can;ZHANG Xiao-xuan;PEI Jing-liang;REN Chun-e(School of Clinical Medicine,Weifang Medical University,Assisted Reproductive Hospital of Weifang Medical University,Weifang 261042)
出处
《生殖医学杂志》
CAS
2022年第10期1348-1354,共7页
Journal of Reproductive Medicine
关键词
宫腔粘连
交联透明质酸钠凝胶
阿司匹林
Intrauterine adhesions
Cross-linked sodium hyaluronate gel
Aspirin
