Ⅲ度以上宫腔粘连宫腔镜分离术后宫腔再粘连的预防

The prevention of adhesion recurrence after hysteroscope management ofⅢ°intrauterine adhesion

目的探讨Ⅲ度以上宫腔粘连宫腔镜分离后宫腔再粘连的预防措施。方法对宫腔镜确诊的11例Ⅲ度以上官腔粘连患者行宫腔镜下粘连分离术,术后采用宫腔置入节育器、透明质酸钠及人工周期、Hegar扩条扩张宫腔等综合措施预防宫腔再粘连。结果11例经扩条定期扩张探查宫腔3～36个月,9例宫腔恢复正常未再粘连,其中6例妊娠。1例正在治疗中,1例失访。结论Hegar扩条扩张宫腔等综合措施预防宫腔再粘连效果确切,尤以扩条扩张探查宫腔最为有效,且简便易行。

Objective To study the prevention of adhesion recurrence after hysteroscope management of severe intrauterine adhesion（IUA）. Methods Hysteroscopic exclusion was performed in 11 patients who were confirmed as severe IUA by hysteroscopy. Combining measures including IUD and sodium hyaluronate placed in uterine cavity,artificial menstrual cycle,uterine cavity dilation with Hegar＇s dilator etc. were taken to prevent re-adhesion after the operations. Results Of the 11 patients undergone regular dilation with Hegar＇s dilator for 3-36 months, shape of uterine cavity of 9 patients returned to normal and no re-adhesion took place. Of the 9 patients, 6 have been pregnant 1 is under treatment and 1 is no longer followed up. Conclusion The combination treatment is quite effective and confirmative in the prevention of recurrence of uterine cavity adhesion,and now uterine cavity dilation with Hegar＇s dilator is proved to be the most effective,convenient.