宫腔镜手术联合术后戊酸雌二醇治疗重度宫腔粘连49例临床分析

Clinical analysis of 49 cases of patients with severe intrauterine adhesions treated by hysteroscopy combined with Estradiol Valerate

目的：观察宫腔镜手术联合术后戊酸雌二醇治疗重度宫腔粘连的方法及临床治疗效果。方法：回顾性分析本院近年来应用宫腔镜手术联合术后戊酸雌二醇治疗重度宫腔粘连患者49例的临床资料、手术方法、治疗效果。结果：49例患者一次性手术成功47例,2例患者因肌性粘连而行2次宫腔镜手术后成功。术中未发生子宫穿孔、宫颈裂伤等并发症。11例月经过少者10例月经量恢复正常,1例较前有所增加;35例闭经患者中33例月经恢复正常;17例周期性腹痛患者疼痛完全消失15例,明显减轻2例;28例要求生育的不孕患者中18例于术后1年内成功受孕,7例于术后1~2年成功受孕。结论：宫腔镜手术联合术后戊酸雌二醇治疗重度宫腔粘连效果肯定,并发症少,值得临床推广应用。

Objective： To observe the methods and clinical therapeutic efficacy of the patients with severe intrauterine adhesions treated by hysteroscopy combined with Estradiol Valerate. Methods： Clinical data, operative method and therapeutic efficacy of 49 patients with severe intrauterine adhesions treated by hysteroscopy combined with Estradiol Valerate were retrospectively analyzed in our hospital. Results： Surgical success in 47 cases, 2 case were given the second operation because of muscular adhesion. There was no uterine perforation, cervical laceration, etc. 10 cases of 11 patients with hypo menorrhea recovered to normal, 1 case slightly increased; 33 cases of 35 cases with amenorrhea recovered to normal; 15 cases of 17 patients with periodic abdominal pain recovered to normal, 2 cases got pain relief; 18 cases of 28 patients infertility conceive successfully within 1 year, and 7 cases conceive successfully during 1-2 years. Conclusion： The efficacy of patients with severe intrauterine adhesions treated by hysteroscopy combined with Estradiol Valerate is affirmed, and less complications it has, so it is worth popularizing.