透明质酸钠宫腔注入联合雌孕激素序贯预防或治疗清宫术后宫腔粘连的临床效果

The clinical effect of Sodium Hyaluronate injection combined with Estrogen and Progesterone in the prevention and treatment of intrauterine adhesions after curettage

目的探讨透明质酸钠宫腔注入联合雌孕激素序贯预防或治疗清宫术后宫腔粘连的临床效果。方法选取2016年1月~2017年3月在我院就诊且具有至少2次人工流产史的200例人工流产及稽留流产患者作为研究对象,采取计算机随机数字分组法将其分为两组,每组各100例。对照组患者术后未采取特殊处理,观察组患者术后经宫腔注入透明质酸钠联合口服雌孕激素。比较两组患者的宫腔粘连发生率、术后出血量及出血持续时间、腹痛持续时间、月经复潮时间、月经减少率及闭经率。结果观察组患者的宫腔粘连发生率明显低于对照组,差异有统计学意义(P<0.05);观察组患者的术后出血量少于对照组,出血持续时间、腹痛持续时间、月经复潮时间均短于对照组,差异有统计学意义(P<0.05);术后3个月,观察组患者的月经量减少率、闭经率均低于对照组,差异有统计学意义(P<0.05)。结论针对多次人工流产及稽留流产患者清宫术后采用透明质酸钠宫腔注入联合雌孕激素序贯治疗,可有效预防术后宫腔粘连的发生,还可有效缓解术后出血、腹痛等症状,有利于促进患者术后月经恢复。

Objective To investigate the clinical effect of sodium hyaluronate injection combined with estrogen and progesterone in the prevention and treatment of intrauterine adhesions after curettage.Methods From January 2016 to March 2017,200 cases of artificial abortion and missed abortion in our hospital who had at least 2 times in the history of artificial abortion were selected as the research objects,they were divided into the control group and the observation group by taking computer random number method, 100 cases in each group.The control group had not taken special treatment after the operation,the observation group had taken intrauterine injection of Sodium Hyaluronate combined with oral Estrogen and Progesterone after the operation.The amount of bleeding of intrauterine adhesions,the incidence of postoperative bleeding duration,duration of abdominal pain,menses time,reduce menstruation rate and amenorrhea rate were compared between two groups.Results The adhesion of uterine cavity in the observation group were significantly lower than the control group,the difference was statistically significant （P〈0.05）;the amount of bleeding in the observation group was less than that in the control group,the duration of bleeding,the duration of abdominal pain,the time of menstruation and tidal repetition were shorter than those in the control group,the differences were statistically significant （P〈0.05）;3 months after surgery,the observation group of reduced rate of menstruation,the rate of closed were lower than the control group, the differences were statistically significant （P〈0.05）.Conclusion The combined Estrogen and Progesterone treated by sequential injection of Sodium Hyaluronate in uterine cavity repeatedly in patients with artificial abortion and missed abortion after curettage can effectively prevent postoperative intrauterine adhesions,but also can effectively relieve postoperative bleeding,abdominal pain and other symptoms,promote the recovery of patients after menstruation.