宫腔镜下宫腔粘连电切术后再粘连的预防方法研究

Study on the prevention of reunion after hysteroscopic resection of intrauterine adhesions

目的探讨宫腔镜下宫腔粘连电切术后再粘连的预防方法。方法以电脑随机编码法将2016年5月～2017年10月在本院接受宫腔镜下宫腔粘连电切术的80例宫腔粘连患者分成40例/组,两组术后均放置Cook球囊支架,对照组1周后取出Cook球囊改为放置节育器,观察组1周后将平宫颈外口剪除Cook球囊导管,继续留置,时间均为1个月。比较两组宫腔粘连程度得分(疗效性指标)、月经模式得分(疗效性指标)、术后并发症发生率(安全性指标)。结果治疗后,观察组的宫腔粘连得分[(6.23±0.01)分]、月经模式得分[(0.26±0.05)分]以及术后置入物脱出、子宫穿孔、术后阴道出血、宫腔感染发生率(2.50%、2.50%、2.50%、5.00%)均低于对照组(P<0.05)。结论宫腔镜下宫腔粘连电切术后长时间放置Cook球囊支架能够有效预防再粘连。

Objective To study the method of preventing hysteroscopy after hysteroscopic resection of intrauterine adhesions.Methods 80 cases of intrauterine adhesions undergoing hysteroscopic intrauterine adhesions were randomLy divided into 40 cases/group in randomized coding method of computer from May 2016 to October 2017 in our hospital.After operation,both groups were placed Cook balloon stent.One week after the control group,the Cook balloon was removed to place the IUD.One week after the observation group,the cervix was cut out of the Cook balloon catheter and continued to be placed for one month.The intrauterine adhesion scores(curative effect index),menstrual model score(curative effect index)and postoperative complication rate(safety index)were compared between the two groups.Results After treatment,intrauterine adhesions score(6.23±0.01),menstrual pattern score(0.26±0.05)and prolapse of the implant,uterine perforation,postoperative vaginal bleeding,the incidence of uterine cavity infection(2.50%,2.50%,2.50%,5.00%)were lower than the control group(P<0.05).Conclusion Hysteroscopic hysteroscopic resection of the helical balloon for prolonged placement of the Cook balloon can effectively prevent reunion.