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重度宫腔粘连电切术后羊膜移植羊膜放置方式临床研究 被引量:2

Clinical study on the placement of amniotic membrane transplantation after severe uterine adhesion electrotomy
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摘要 目的研究羊膜移植(AMT)预防宫腔粘连(IUA)术后再粘连中,羊膜放置方式对患者术后月经恢复及子宫内膜修复的影响。方法将2015年6月至2017年1月该院收治的46例重度宫腔粘连患者随机分为上皮层组(25例)和基质层组(21例)。所有患者均接受超声引导下宫腔粘连电切术(TCRA),术中同时行羊膜移植术,上皮层组行羊膜移植时将羊膜上皮面贴附于宫腔内,基质层组将羊膜基底层贴附于宫腔内。术后1、3个月于门诊随访妇科超声及宫腔镜检查,记录患者月经恢复情况、子宫内膜厚度、美国生育协会(AFS)评分及妊娠情况。结果 (1)2组患者术后月经均得到改善,上皮层组术后AFS评分均较基质层组降低,差异均有统计学意义(P<0.05);(2)2组患者术后子宫内膜厚度均较术前增加,差异均有统计学意义(P<0.05);但组间术后比较,差异无统计学意义(P>0.05)。结论宫腔粘连术后行羊膜移植,将羊膜上皮面贴附向宫腔较将基底层贴附向宫腔能够更好地改善术后AFS评分,但对术后子宫内膜厚度无显著影响。 Objective To study the effect of AMT on the postoperative recovel3z and endometrial repair of patients af- ter the operation of IUA. Methods 46 cases of severe uterine adhesion patients admitted to the hospital fi'om June 2015 to Jan- uary 2017 were randomly divided into the upper cortical group (25 eases) and the matrix layer group (21 eases). All patients underwent ultrasound-guided intrauterine adhesion electrotomy (TCRA) , and amniotic membrane transplantation ,was perfomled at the same time. The upper amniotic skin surface ,was attached to the uterine cavity in the epidermis group and the substratum ,was attached to the uterine cavity in the stromal group. Follow-up gynecologic ultrasonography and hysteroscopy ,were peffomled in the outpatient department in 1 and 3 months after surgel3z, and the patients' menstrual recovel3z, endometrial thickness, AFS score and pregnancy were recorded. Results (1)The postoperative period of the two groups were improved, and the AFS score in the upper cortical group ,was lower than that of the matrid layer group, and the differences ,were statisti- cally significant (P〈0.05). (2)The endometrial thickness of both groups ,was increased after surgel3z, but there ,was no statisti- cally significant difference between the two groups (P〉0.05). Conclusion Placing the epithelial layer towards the uterine cav- ity can improve the AFS score compared with placing thestroma layer towards the uterine cavity in amniotic membrane trans- plantation. The way of placing the amniotic membrane have little effect on the endometrium trickiness as so far.
作者 吴本媛 王佳 WU Benyuan;WANG fiaA(Department of Obstetrics and Gynecology,University Town Hospital of Chongqing Mecdical University,Chongqing 401331,China)
出处 《现代医药卫生》 2018年第20期3128-3131,共4页 Journal of Modern Medicine & Health
基金 重庆市卫生和计划生育委员会医学科研计划项目(20141014)
关键词 宫腔镜检查 电外科手术 子宫疾病/外科学 黏连/外科学 羊膜/移植 宫腔粘连 放置方式 Hysteroscopy Electrosurgery Uterine diseases/surgery Adhesions/surgery Anmion/transplantation Intrauterine adhesion Placement mode
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