医用几丁糖预防宫腔粘连分离后再粘连的价值

The clinical value of Chitosan in prevention of re-adhesion after separation of intrauterine adhesions

目的探讨医用几丁糖在预防宫腔粘连分离后再粘连的临床价值。方法选取2012年6月至2014年6月在广西壮族自治区人口和计划生育委员会生殖中心收治的宫腔粘连行分离术80例患者资料,将40例术后宫腔内注入医用几丁糖的患者作为观察组,40例术后宫腔内不做特殊处理患者为对照组,两组均行人工周期治疗,对比分析两组患者术后宫腔粘连情况和术后阴道流血,月经恢复情况。结果观察组宫腔粘连的分离效果显著率77.5%(31/40),高于对照组37.5%(15/40)(P<0.05);观察组患者阴道流血及腹痛的持续时间、月经复潮的时间分别为(3.75±0.89)d、(25.21±6.45)d及(27.59±5.46)d,均短于对照组[(6.12±1.31)d、(37.28±8.74)d、(37.34±6.78)d](P<0.05)。观察组术后并发症发生率10.0%(4/40),低于对照组的17.5%(7/40)(P<0.05)。结论在宫腔粘连分离术后对患者宫腔进行医用几丁糖注入,结合人工周期治疗,能够较好的预防宫腔粘连分离后再粘连,促进患者正常月经周期及经量的恢复。

Objective To explore the clinical value of Chitosan in prevention of re - adhesion after separation of intrauterine adhesion . Methods Clinical data of 80 patients with intrauterine adhesion underwent separation operation in Reproductive Center of Population and Family Planning Commission of Guangxi Zhuang Autonomous Region from Jun 2012 to Jun 2014 were selected. 40 patients intrauterine injected Chitosan after the surgery were as observation group, 40 patients without special treatment after the surgery were as control group, patients in both groups were given artificial cycle therapy. The intrauterine adhesion after operation, postoperative vaginal bleeding, menstruation resume of two groups were compared. Results The effective separation rate of observation group 77.5 % （ 31/40 ） was higher than that of the control group 37.5 % （ 15/40 ） （ P 〈 0. 05 ）. The duration of vaginal bleeding, duration of the abdominal pain, and menstruation resume period of observation group[ （ 3. 75 ± 0. 89 ） d, （ 25.21 ± 6.45 ） d, （27.59±5.46） d respectively] were shorter than those of group [（6. 12 ± 1.31） d, （37.28 ± 8.74） d, （37.34 ± 6.78） drespectively] （P 〈 0.05 ）. The postoperative complication rate of research group 10 % （4/40） was lower than that of control group 15 % （7/40） （ P 〈 0.05 ）. Conchlsion Chitosan injection combined with artificial cycle therapy in treating re - adhesion after separation of intrauterine adhesion have a good prevention effect, which promote recovery of menstrual flow and amount.