促性腺激素释放激素激动剂预防子宫纵隔切除术后宫腔粘连的初步研究

Pilot study of gonadotropin-releasing hormone agonist for preventing uterine adhesion after transcervical hysteroscopic resection of uterine septa

目的探讨促性腺激素释放激素激动剂(GnRH-a)在子宫纵隔宫腔镜切除术后预防宫腔粘连的作用。方法 12例患者均经宫腹腔镜检查诊断为子宫纵隔,同时合并子宫内膜异位症、子宫肌瘤、子宫腺肌症。所有患者行宫腔镜下子宫纵隔切除术,同时行腹腔镜下子宫内膜异位病灶烧灼术、卵巢子宫内膜异位囊肿剥除术、子宫肌瘤剔除术。术后注射GnRH-a 2～3个月之后复查宫腔镜。结果所有患者术后复查宫腔镜,仅1例患者宫腔见轻微粘连,其余均未见粘连。结论 GnRH-a可有效预防宫腔镜子宫纵隔切除术术后宫腔粘连,尤其适用于雌激素应用禁忌的患者。

Objective： To investigate the effects of gonadotropin-releasing hormone agonist （GnRH-a）forpreventing uterine adhesion after transcervical hysteroscopic resection of uterine septa（TCRS）. Methods： Twelve women diagnosed as uterine septa with either endometriosis, myoma or adenomyosis diagnosed by hysteroscopic and laparoscopic examination was treated by TCRS and laparoscopy. GnRH-a was used postoperatively for 2-3 months, and then second hysteroscopic examination was scheduled for each patient. Results： All patients had normal uterine cavity except one patient had only minimal adhesion. Conclusion： This primary study suggests that GnRH-a therapy is useful and effective for prevention of uterine adhesion after TCRS in patients with contraindication of estrogen therapy.