子宫中隔电切术后宫腔放置医用生物蛋白胶和水囊的临床疗效

Employment of Intrauterine Fibrin Sealant with Water Bag Instead of Intrauterine Device After Laparoscopy Combined with Hysteroscopy Trans-cervical Resection of Septus

目的:探讨腹腔镜监视下子宫中隔电切术后宫腔放置医用生物蛋白胶和水囊代替宫内节育器(IUD)的临床疗效。方法:将子宫中隔患者69例,随机分成3组,实施腹腔镜监视下子宫中隔电切术治疗,术后治疗组1宫腔内放置弗莱氏尿管,注入4 ml生理盐水形成水囊并经尿管注入生物蛋白胶封管,留置1 d后取出并使用雌孕激素人工周期序贯疗法;治疗组2方法同治疗组1,但水囊留置3 d;对照组放置IUD并使用雌孕激素人工周期序贯疗法。比较3组患者术后阴道流血时间、腰腹部疼痛和3月后宫腔镜检查宫腔情况。结果:宫腔放置医用生物蛋白胶和水囊的治疗组1有1例宫腔膜状粘连,治疗组2与放置IUD的对照组宫腔均无粘连,三者两两比较无显著性差异(P>0.05);患者阴道流血时间治疗组2较对照组明显缩短,治疗组1和2腰腹部疼痛时间较对照组明显延长,比较均有显著性差异(均为P<0.05);而治疗组1和治疗组2之间比较无显著性差异(P>0.05)。结论:腹腔镜监视下子宫中隔电切术后放置医用生物蛋白胶和水囊与宫内放置IUD疗效相同,而阴道流血时间和腰腹部疼痛时间短,是宫腔放置IUD的有效替代治疗方式。

Objective： To compare the efficacy of intrauterine Fibrin Sealant with water bag instead of intrauterine device （IUD） after laparoscopy combined with hysteroscopy trans-cervical resection of septus （TCRS）. Methods： This was a retrospective study of 69 cases of TCRS. They were divided into three groups based on water bag reserved time, Fibrin Sealant and IUD（employment）. The intrauterine adhesion, uterine bleeding and sub-abdominal pain were observed after operation for three months. Results： Second hysteroscopy showed only one case in treatment group Ⅰ （ the water bag placed for one day ） had adhesion after three months, and no intrauterine adhesion was found in treatment group Ⅱ （the water bag was placed for three days） and IUD group （control group）. The IUD group had uterine bleeding and sub-abdominal pain for a longer time （P〈 0.05）. And there was no difference between the two treatment groups （P〉0.05）. Conclusion：Using intrauterine Fibrin Sealant with water bag instead of IUD has the same efficacy in preventing adhesion and could reduce the time of uterine bleeding and sub-abdominal pain.