宫腔粘连的预防方法研究进展

Research Progress in the Prevention Method of Intrauterine Adhesion

宫腔粘连是导致不孕症的妇科常见病之一,严重危害育龄期女性生育功能及心理健康,妊娠期宫腔操作是主要原因。其发病率随宫腔操作机会增加而升高。宫腔镜检查是诊断金标准,宫腔镜下宫腔粘连分离术(transcervical resection of uterine adhesions,TCRA)是治疗的标准术式,轻度宫腔粘连治疗效果好,但中、重度宫腔粘连治疗效果欠佳,复发率高。预防宫腔粘连的方法众多,有预防性使用抗生素、口服雌激素、宫腔内注入透明质酸钠、放置宫内节育器或球囊支架等,现尚无统一标准。宫腔粘连治疗多采用TCRA+防粘连材料+人工周期的综合治疗方案,效果较单纯宫腔镜下宫腔粘连分离术好。

Intrauterine adhesion（IUA） is one of the common causes of infertility gynecological diseases,which dose serious harm to the reproductive function and mental health of women who are childbearing age,and the main reason is pregnancy uterine cavity operation.The incidences rate increases with the increase in intrauterine operation.Hysteroscopy is the diagnostic criteria,and transcervical resection of uterine adhesions（TCRA） is the standard surgical procedure.The mild intrauterine adhesions treatment effect is good,but the recurrence rate of moderate intrauterine adhesions and severe intrauterine adhesions are high.There are many methods to prevent IUA,prophylactic use of antibiotics,oral estrogen,intrauterine injection of sodium hyaluronate,placement of intrauterine device or balloon stent,etc.but there is no uniform standard.It is always using TCRA ＋anti-adhesion material ＋artificial cycle of comprehensive treatment program to treat intrauterine,and the effect is better than hysteroscopic uterine cavity adhesion.