加用防粘连膜的综合方法治疗重度宫腔粘连的临床效果观察

Clinical Effect Observation of Comprehensive Treatment Method with Absorbable Adhesion Barrier in the Treatment of Severe Intrauterine Adhesions

目的:探讨加用防粘连膜(Interceed)的综合治疗方法治疗重度宫腔粘连的临床效果。方法:34例重度宫腔粘连患者,随机分成2组。A组行宫腔镜下宫腔粘连分离术(TCRA),分离后放置宫内节育器(IUD),术后口服大剂量戊酸雌二醇(E2V)10 mg/d;B组亦先行TCRA,在放置IUD同时置入Interceed,术后治疗同A组。3个月后再次行宫腔镜检查术,评估对宫腔粘连的治疗效果。结果:B组的完全治愈率高于A组(A、B组分别为0.0%、47.4%,P=0.002),宫腔再粘连率低于A组(A、B组分别为100.0%、52.6%,P=0.002),其治疗总有效率明显优于A组(A、B组分别为66.7%、100.0%,P=0.000)。A、B两组的妊娠率分别为13.33%(2/15)、10.53%(2/19),两组妊娠率差异无统计学意义(P=0.804)。结论:加用Intrceed的综合治疗方法治疗重度宫腔粘连一次分离术后的疗效优于传统综合治疗方法。

Objective：To explore the clinical effect of two comprehensive methods with or without absorbable adhesion barrier（Interceed） in the treatment of severe intrauterine adhesions. Methods：34 cases with severe intrauterine adhesion were randomly divided into 2 groups. Group A installed intrauterine device（IUD） after transcervical resection of adhesions（TCRA ）, oral administration of high dose estradiol valerate （E2 V） 10 mg/d. Group B installed IUD and Interceecl after TCRA,and underwent the same postoperative treatment with group A. Reoperation of hysteroscopy was done to evaluate the treatment effect of IUA after 3 months. Reeults：A lower recurrence rate（100% for group A,52.6% for group B ） and a lighter degree of second ad- hesion for Group B was observed than those of group A （ P 〈 0.05 ）. The cure rate （0.0% for group A, 47. 4% for group B） and the total effective rate（66.7% for group A,100% for group B ） of group B were significantly higher than that of group A（ P〈0.05 ）. The pregnant rate of group A and group B were separately 13. 33% （2/15）and 10. 53% （2/19）, and there was no significant difference between the 2 groups （ P 〉 0.05）. Conclusions： Comprehensive treatment combined with Interceed has a better effect than traditional comprehensive treatment method on the prevention of the secondary intrauterine adhesion after TCRA.