摘要
目的研究不同剂量戊酸雌二醇术前应用对重度宫腔粘连治疗结局的影响。方法选取2012年9月—2016年7月郑州市妇幼保健院收治的重度宫腔粘连手术患者150例,根据随机数字表法将患者分为A组、B组和C组,每组50例。其中A组术前不给予预处理,B组给予戊酸雌二醇(2 mg/次,1次/d),C组给予戊酸雌二醇(2 mg/次,2次/d),共21 d,B、C两组均术前用药3个月,用药第11 d口服黄体酮胶丸(0.1 g/次,2次/d),共10 d。入组患者均行腹腔镜监视下TCRA术,术后宫腔放置球囊、涂抹医用几丁糖。术后3组均给予戊酸雌二醇(2 mg/次,2次/d),共21 d,用药第11 d口服黄体酮胶丸(0.1g/次,2次/d),共10 d。治疗3个月经周期。治疗后观察3组患者月经恢复情况及5天、3个月行宫腔镜检查宫腔形态恢复情况及术后1年妊娠率,并比较3组患者宫腔形态恢复情况、月经恢复率及术后1年内妊娠率。结果①月经恢复情况:手术前月经量各组间无明显差距(P>0.05),手术后3个月各组患者月经量明显增加,A组<B组<C组,差异有统计学意义(P<0.05)。②术后3个月宫腔镜了解子宫恢复情况,A组有效率54%,B组有效率74%,C组有效率90%,A组<B组<C组,有统计学差异(P<0.05)。③术后1年妊娠情况,A组妊娠率20%,B组妊娠率38%,C组妊娠率38%,妊娠率A组<B组、C组,有统计学差异(P<0.05)。结论每天应用4 mg戊酸雌二醇应用于重度宫腔粘连术前预处理,对重度宫腔粘连术后具有较好的疗效,能有效促进患者月经恢复,有效防止宫腔再粘连。
Objective To study the effect of different doses of estradiol valerate pretreatment in outcome of severe intrauterine adhesions after transcervical resection.Methods Totally 150 patients with severe uterine adhesion surgery were selected from September 2012 to July 2016 in our hospital,and the patients were divided into group A,group B and group C,50 cases in each group according to the random digital table method.Does not offer pretreatment including preoperative group A,B group was given estradiol valerate2 mg/1/d,group C was given estradiol valerate 2 mg/2/d,The two gropes were given estradiol valerate 21 days,BC in the two groups were preoperative medication for 3 months,medicine oral progestin capsule 0.1 g/day 11 times,2 times/day,A total of 10 days.A11 patients were performed TCRA surgery by laparoscopy,and the cavity was placed the medical chitosan was applied.After operation the three groups were given 2 mg/twice 2 timesd,21 days in total and 1 g second 2 times/day,10 days.Treat 3 menstrual cycles.To observe the improvement of their menstruation,the degree of adhesions and the rate of pregnancy.Results①Menstruation:preoperative use estradiol valerate has no obvious disparity between the number of each group(P>0.05),and 3 months after the operation,the patients with the estradiol valerate use quantity increased obviously,A<B<C,the difference was statistically significant(P<0.05).②The degree of adhesions:Three months later after operation,In A group,the effective rate reached 54%,In B group the effective rate reached 74%,In C group the effective rate reached 90%,the patients with the estradiol valerate use quantity increased obviously,A<B<C,the difference was statistically significant(P<0.05).③The rate of pregancy In)A group,the rate reached 20%,In B group the)rate?reached 38%,In C group the)rate?reached 38%,The effective rate of B、C group were higher)than A group(P<0.05).Conclusion Effect of application of 4 mg per day estradiol valerate in preventing re-adhesion after transcervical resection of i
作者
刘路玖
刘爱珍
郭宝芝
丁俊珊
LIU Lu-jiu;LIU Ai-zhen;GUO Bao-zhi;DING Jun-shan(Zhengzhou Women and Children Healthcare Hospital,Zhengzhou 450051,China)
出处
《医药论坛杂志》
2019年第4期51-53,58,共4页
Journal of Medical Forum
