宫腔镜下微型剪刀配合微电极分离宫腔粘连疗效评价

Evaluation of hysteroscopic micro-scissors combined with microelectrode separation for intrauterine adhesions

目的分析评价宫腔镜微型剪刀配合微电极分离宫腔粘连(intrauterine adhesions,IUA)的临床疗效。方法选取2015年1月至2016年10月在乐山市人民医院因IUA住院行宫腔镜下微型剪刀配合微电极治疗的患者56例为观察组,其中轻度粘连30例,中度粘连26例。另选取2013年6月至2014年12月50例IUA行普通宫腔镜电切术的患者为对照组,其中轻度粘连22例,中度粘连28例。两组患者术毕均宫腔安置相应型号宫内节育器,并口服戊酸雌二醇片和黄体酮胶囊周期治疗。术后3月复查宫腔镜和超声测量子宫内膜厚度,统计月经改善情况。结果术后3月,观察组轻度和中度IUA患者总有效率分别为96.7%和88.5%;对照组分别为90.90%和78.57%;两组比较差异有统计学意义(P<0.05);两组患者子宫内膜厚度均增加,观察组增加更为明显,差异有统计学意义(P<0.05);两组患者月经均有改善,观察组优于对照组,差异有统计学意义(P<0.05)。结论宫腔镜下微型剪刀配合微电极分离轻、中度IUA可减少普通电切术后导致的宫腔再次粘连。

Objective To evaluate the clinical efficacy of hysteroscopic micro scissors combined with microelectrode separation for treating intrauterine adhesions （IUA）. Methods Selected 56 patients underwent hysteroscopic micro - scissors with micro - electrode treatment due to IUA in January 2015 to October 2016 in People＇ s Hospital of Leshan as observation group, including 30 cases of mild adhesion and 26 cases of moderate adhesion. Another 50 cases from June 2013 to December 2014 IUA patients underwent conventional hysteroscopic resection were selected as the control group, including 22 cases of mild adhesion and 28 cases of moderate adhesion. Both groups of patients had intrauterine device placed , and oral pentanoic acid estradiol and progesterone capsules treatment cycle after the surgery. Postoperative review of hysteroscopy, uhrasound measurements of endometrial thickness and statistics on the improvement of menstruation in 3 months after the surgery were done. Results The effective rates were 96. 7% and 88.5% in the mild and moderate IUA patients in the observation group, and 90. 90% and 78.57% in the control group respectively. The difference between the two groups was statistically significant （ P 〈 0. 05 ）. The thickness of endometrium increased in both groups, and the difference was statistically significant （ P 〈 0. 05 ）. Both groups of patients had improved menstruation, the observation group was better than the control group, the difference was statistically significant （ P 〈 0. 05 ）. Conclusion Hysteroscopic micro - scissors with microelectrode separation of light, moderate IUA can reduce the common electrosurgery after the uterine cavity caused by re - adhesion.