B超联合宫腔镜治疗宫腔粘连及术后预防

B-Ultrasound combined hysteroscopy treatment of intrauterine adhesions and postoperative prevention

目的探讨B超联合宫腔镜治疗宫腔粘连及术后预防。方法选取2012年1月-2014年12月收治入院的宫腔粘连行B超联合宫腔镜宫腔粘连分离术患者100例的临床资料,随机分为两组,每组50例,观察组50例患者采用医用透明质酸钠凝胶＋球囊＋口服补佳乐及安宫黄体酮,对照组50例患者采用节育器＋口服补佳乐及安宫黄体酮,观察两组患者宫腔再粘连情况（分级）、子宫内膜修复（月经改善情况）、并发症发生情况,并进行统计学分析。结果观察组患者术后宫腔再粘连发生率明显低于对照组,两组比较差异有统计学意义（P〈0.05）;观察组患者总有效率为86.0%,明显高于对照组总有效率76.0%,两组患者总有效率比较差异有统计学意义（P〈0.05）;所有患者均无子宫穿孔、感染、大出血、水中毒及脏器损伤等并发症。结论 B超联合宫腔镜是诊治宫腔粘连有效及安全的方法,宫腔粘连程度越重,月经越难恢复,粘连越易复发,联合医用透明质酸钠凝胶＋球囊＋口服补佳乐及安宫黄体酮,可有效防止再粘连。

Objective To study B-Ultrasound combined with hysteroscopy treatment on intrauterine adhesions and the postoperative prevention. Methods 100 patients with intrauterine adhesions,who were recieved and treated with synechiotomy by B-Ultrasound combined hysteroscopy in our hospital from January 2012 to December 2014,were selected as the clinical data,were randomly divided into two groups,with 50 cases in each group. To observe the uterine cavity re-adhesion（classification）,endometrium regeneration（menstrual improvement satuation）,the occurrence satuation of complications in observation group of 50 patients,who were treated with medical sodium hyaluronate gel＋balloon＋oral progynova and medroxyprogesterone,and control group of 50 patients,who were treated with contraceptive device＋oral progynova and medroxyprogesterone,to make statistic analysis. Results The incidence of uterine cavity re-adhesion in observation group was obviously lower than which in control group,the total effective rate in observation group（86.0%） was obviously higher than which in control group（76.0%）,the differences were statically significant（P〈0.05）.There was no complication,such as uterine perforation, infection,massive hemorrhage,water intoxication,and organ injury and so on. ConclusionB-Ultrasound combined hysteroscopy diagnosis and treatment on intrauterine adhesions is effective and safety method,could effectively prevent re-adhesion, when adhesions degree is more severe,adhesions is more easy recurrence,and menstruation is more difficult recovery,which should be treated combined with medical sodium hyaluronate gel＋balloon＋oral progynova and medroxyprogesterone.