双腔导尿管联合赛必妥宫腔注射及宫血宁治疗中重度宫腔粘连的临床研究

Clincal research in the treatment of moderate to severe in trauterine adhesions with double-lumen catheter combined surgical anti-adhesion solution intrauterine injection and Gongxuening

目的探讨双腔导尿管联合赛必妥宫腔注射及宫血宁治疗中重度宫腔粘连的临床疗效。方法 93例中重度宫腔粘连患者经宫腔镜检查确诊后,随机分成对照组(术后采用戊酸雌二醇治疗,38例)和观察组(戊酸雌二醇治疗基础上加用双腔导尿管联合赛必妥宫腔注射及宫血宁,55例),定期随访观察术后宫腔形态形成、月经恢复、粘连复发及妊娠情况。结果观察组和对照组正常宫腔形成分别为74.54%、52.63%;月经改善率分别为85.45%、57.89%,无一例闭经;粘连复发率分别为18.18%、47.37%;术后妊娠率分别为52.73%、23.68%;上述各指标两组间比较差异均有统计学意义(P<0.05),两组无术后病死率及周期性腹痛。结论双腔导尿管联合赛必妥宫腔注射及宫血宁治疗中重度宫腔粘连分离术后可有效防止宫腔再粘连,促进月经恢复及妊娠率。

Objection To evaluate the efficacy of double-lumen catheter combined surgical anti- adhesion solution intrauterine injection and Gongxuening in the treatment of moderate to severe intrauterine adhesions. Methods 93 cases patients with moderate-severe asherman＇s diagnosed by hysteroscopy were randomly divided into the observation group（55 cases） and the control group （38 cases）. Uterine morphogenesis, menstruation, adhesion recurrence and pregnancy situation were observed regularly after the operation. Results After the operation the ratio of normal uterine morphogenesis, Menstrual improvement, adhesion recurrence and pregnancy were respectively 74.54%, 57.89%, 18.18% and 52.73% in the observation group while the ratio were respectively 52.63%, 65.0%, 47.37% and 23.68% in the control group. There was significant difference between the observation group and the control group （P〈0.05）. In both groups no one died and periodic abdominal pain occurs. Conclusion Intrauterine adhesions again may be effectively prevented as well as menstruation and pregnancy may be promoted by the treatment of ariti-adbesion solution intrauterine injection combined double- lumen catheter and Gongxuening after moderate-severe intrauterine adhesions.