宫腔镜下宫颈、宫腔粘连分离术后口服雌激素对患者月经、宫腔再粘连以及妊娠结局的影响

The effect of estrogen in oral on the menstruation,intrauterine adhesions again and pregnancy outcomes in patients postoperative cervical caused by transcervical resection adhesion under hysteroscopy

目的观察大剂量雌激素对中重度宫腔粘连(IUA)宫腔镜宫腔粘连分离术(TCRA)后患者预防宫腔再粘连的疗效。方法选取行TCRA的中重度IUA患者50例作为研究对象。根据术后服用雌激素剂量不同分为试验组和对照组各25例。试验组患者服用大剂量雌激素;对照组患者服用正常剂量雌激素。比较2组患者治疗后月经改善、宫腔再粘连、妊娠情况和药物不良反应。结果试验组患者月经改善有效率为80.0%明显高于对照组的52.0%,差异有统计学意义(P<0.05)。术后第4个月对患者进行随访,行宫腔镜探查。试验组术后宫腔再粘连发生率为24.0%(6/25)低于对照组的48.0%(12/25),差异有统计学意义(P<0.05)。2组间妊娠率、分娩率比较差异均无统计学意义(P>0.05)。2组药物不良反应发生率比较差异无统计学意义(P>0.05)。结论大剂量雌激素能够有效预防中重度IUA患者TCRA术后宫腔再粘连,并且无明显不良反应。

Objective To observe the effect of estrogen in oral on the menstruation,intrauterine adhesions again and pregnancy outcomes in patients with severe,moderate intrauterine adhesion（IUA） postoperative cervical caused by transcervical resection adhesion（TCRA） under hysteroscopy.Methods 50 cases patients with severe,moderate intrauterine adhesion（IUA） postoperative cervical caused by transcervical resection adhesion（TCRA） under hysteroscopy were randomly divided into test group and control group,each of 25 cases.Test group was treated by high doses of estrogen,the control group was treated by normal doses of estrogen.After treatment,compared the menstruation,intrauterine adhesions again,pregnancy outcomes and adverse drug reactions of 2 groups.Results The efficient of menstrual improvement in test group（80.0%） was higher than that of control group（52.0%）,the difference was statistic significantly（P〈0.05）.4 months later,take follow-up by hysteroscopy examination,The intrauterine adhesions again rate of test group（24.0%） was lower than that of control group（48.0%）,the difference was statistic significantly（P〈0.05）.The rate of pregnancy,childbirth and adverse drug reactions of 2 groups was no statistic significantly（P〉0.05）.Conclusion Large dose of estrogen can efficacy prevent the intrauterine adhesions again of severe,moderate IUA after TCRA,and no adverse durg reaction.