几丁糖预防人工流产术后宫腔粘连效果分析

Analysis on the effect of chitosan on prevention of intrauterine adhesion after artificial abortion

目的:探讨几丁糖预防人工流产术后宫腔粘连的临床应用价值。方法:将400例因早孕要求进行人工流产手术的重复流产患者按随机数字表法分组,即几丁糖子宫腔内局部应用组(试验组)及无任何干预措施组(对照组),对两组病例手术中情况、术后月经量变化情况、宫腔改变情况进行比较。结果:两组病例的一般情况、手术中情况无差异;手术时间无差异(t=0.953,P=0.341);术后绒毛大小无差异(t=-0.256,P=0.799);术后月经量减少30%～50%者试验组为6例,对照组为19例;术后月经量减少≥50%者试验组2例,对照组6例,两组差异有统计学意义(χ2=9.55,P=0.005);术后发生宫腔粘连试验组2例,对照组6例,两组差异有统计学意义(χ2=7.35,P=0.007)。结论:宫腔内应用几丁糖可以减少人工流产术后宫腔粘连的发病几率,是一种操作简便、疗效满意的预防方案。

Objective：To explore the clinical application value of chitosan in prevention of intrauterine adhesion after artificial abortion. Methods：A total of 400 cases with recurrent spontaneous abortion who demanded artificial abortion because of early pregnancy were divided into experimental group（treated with chitosan） and control group（without any interventional measures） according to random number table,the intraoperative conditions,the changes of amount of menstrual bleeding and uterine cavity after operation in the two groups were compared. Results：There was no significant difference in the general condition and intraoperative conditions between the two groups;there was no significant difference in the operation time（t=0.953,P=0.341） and the size of villi after operation（t=-0.256,P=0.799） between the two groups;the amounts of menstrual bleeding of 6 patients in experimental group decreased by 30%-50%,while the amounts of menstrual bleeding of 19 patients in control group decreased by 30%-50%;the amounts of menstrual bleeding of 2 patients in experimental group decreased by more than 50%（including 50%）,while the amounts of menstrual bleeding of 6 patients in control group decreased by more than 50%（including 50%）,there was significant difference between the two groups（χ2=9.55,P=0.005）.After operation,two patients in experimental group were found with intrauterine adhesion,and six patients in control group were found with intrauterine adhesion,there was significant difference between the two groups（χ2=7.35,P=0.007）. Conclusion：Chitosan used in uterine cavity can reduce the incidence of uterine adhesion after artificial abortion,which is a simple and effective preventive method.