66例宫腔粘连分离术后戊酸雌二醇联合地屈孕酮预防再发粘连的疗效分析

Clinical Analysis of 66 Cases in Preventing Readhesion by Taking Estradiol Valerate Combined with Dydrogesterone after Transcervical Resection

目的探讨宫腔粘连分离术后口服戊酸雌二醇(补佳乐)联合地屈孕酮片(达芙通)在预防再次发生宫腔粘连中的临床价值。方法选取2012年6月至2014年6月我院就诊的132例中度宫腔粘连患者,随机分为实验组66例和对照组66例。所有患者行宫腔粘连分离术,术后实验组序贯口服戊酸雌二醇联合地屈孕酮片行人工周期治疗3个月,对照组口服戊酸雌二醇治疗3个月,观察治疗期内的月经情况及不良反应,术后第3个月月经干净后行宫腔镜检查宫腔形态及内膜生长情况,随访至1年观∶察两组月经、宫腔形态及妊娠情况。结果实验组治疗后月经恢复率为97.0%,对照组为84.8%,差异有统计学意义(P<0.05);实验组治疗后宫腔粘连再次发生率及妊娠率与对照组比较,差异无统计学意义(P>0.05)。结论宫腔粘连分离术后口服序贯戊酸雌二醇联合地屈孕酮片较用戊酸雌二醇月经恢复率高,疗效更满意,两种给药方案的宫腔粘连再次发生率及1年内妊娠率无明显差别。

OBJECTIVE To evaluate the effect of estradiol valerate combined with dydrogesterone in preventing readhesion after transcervical resection（ TCRA） for moderate intrauterine adhesion（ IUA）. METHODS 132 cases of moderate IUAs were selected from June 2012 to June 2014 and randomly divided into two groups after been treated with TCRA. Patients in study group（ n = 66） were treated with sequential oral estradiol valerate combined with dydrogesterone tablets for 3 months by artificial cycle,while patients in control group（ n = 66） were treated with estradiol valerate for 3 months. Menstruation and adverse reactions were observed within treatment period. All patients were given an examination in the third month by hysteroscopy to measure the thickness of endometrium and uterine cavity,and they were fellowed up for one year by ultrasound test to measure menstrual conditions,uterine cavity and pregnancy. RESULTS The 97. 0% menstruation recovery of the patients was observed in study group,and 84. 8%in the control group. Menstruation recovery in study group was better than those in control group（ P〈0. 05）. But not difference was statistically significant in the rate of readhesion and pregnancy between the two groups（ P〈0. 05）.CONCLUSION Treatment by taking estradiol valerate combined with dydrogesterone after operation has more advantage of menstruation recovery. And there was no difference in the rate of readhesion and pregnancy between the two groups.