两种剂量戌酸雌二醇联合宫腔镜治疗重度宫腔粘连的效果观察

Clinical efficacy of two doses of post-hysteroscopic estradiol valeriate for severe intrauterine adhesions

目的观察宫腔镜术后两种剂量戌酸雌二醇治疗重度宫腔粘连的效果。方法 86例重度宫腔粘连患者采用宫腔镜治疗,术后第3天服用8 mg/d(对照组)或16 mg/d(观察组)戌酸雌二醇,连用21 d,后5 d加用10 mg/d黄体酮,共3个疗程;比较两组疗效、复发率、子宫体积、月经量及不良反应。结果观察组总有效率高于对照组(86.0% vs 67.4%),复发率低于对照组(16.3% vs 34.9%),子宫体积明显大于对照组[(43.85±7.39)cm^3 vs(38.56±5.28)cm^3],治疗后第1~3个月的月经量也明显多于对照组,差异均有统计学意义(P<0.01或0.05)。两组不良反应差异无统计学意义(P>0.05)。结论 16 mg/d戊酸雌二醇可有效预防重度宫腔粘连术后复发。

Objective To observe the effect of two doses of post-hysteroscopic estradiol valeriate on severe intrauterine adhesions （IUA）. Methods Eighty-six patients with severe IUA underwent hysteroscopy, and then received 8 mg/d （control group） or 16 mg/d （observation group） estradiol valeriate for 21 days on day 3 after operation and 10 mg/d progesterone for the last 5 days. Clinical efficacy, recurrence rate, uterine volume, menstrual quantity and adverse reactions were compared between two groups after 3 courses of treatment. Results Compared with control group, overall effective rate （86.0% vs 67.4%）, uterine volume [（43.85± 7.39） cm3 vs （38.56±5.28） cm3], and menstrual quantity after 1-3 months were increased, but recurrence rate decreased （16.3% vs 34.9%） in observation group （P〈0.01 or 0.05）. Adverse reactions showed no significant difference between two groups （P〉0.05）. Conclusion High-dose estradiol valeriate （16 mg/d） can effectively prevent the postoperaive recurrence of severe IUA.