中重度宫腔粘连术后预防短期内再次粘连的3种方法效果比较

Comparison of three methods in prevention of intrauterine re-adhesion in patients with moderate to severe intrauterine adhesions

目的探讨中重度宫腔粘连术后宫腔放置节育环、Foley球囊导尿管及自交联透明质酸钠凝胶这3种方法预防短期内再次粘连的效果。方法选取术前经宫腔镜检查确诊为中度、重度宫腔粘连的患者150例,行腹腔镜监护宫腔镜下宫腔粘连电切术,术后分别予以宫腔放置节育环、Foley球囊导尿管、自交联透明质酸钠凝胶,观察并比较这3种方法在3个月内改善月经情况及预防再次粘连方面的效果。结果术后放置宫内节育器组(n=50)术后1、3个月月经改善率分别为80. 0%(40/50)、64. 0%(32/50),术后1、3个月宫腔再次粘连的发生率分别为16. 0%(8/50)、20. 0%(10/50);术后放置Foley球囊导管组(n=50)术后1、3个月月经改善率分别为78. 0%(39/50)、58. 0%(29/50),术后1、3个月宫腔再次粘连的发生率分别为18. 0%(9/50)、24. 0%(12/50);术后放置自交联透明质酸钠凝胶组(n=50)术后1、3个月月经改善率分别为74. 0%(37/50)、60. 0%(30/50),术后1、3个月宫腔再次粘连的发生率分别为20. 0%(10/50)、24. 0%(12/50)。结论中重度宫腔粘连患者在腹腔镜监护宫腔镜下宫腔粘连电切术后,采用宫腔放置节育环、Foley球囊导尿管、自交联透明质酸钠凝胶这3种方法,在短期内改善月经情况及预防再次粘连方面的效果相当。

Objective To investigate effect of intrauterine contraceptive ring,Foley balloon urethral catheter,and self-crosslinking sodium hyaluronate gel after operation in prevention of short-term re-adhesion in patients with severe intrauterine adhesions.Methods A total of 150 patients diagnosed as moderate to severe intrauterine adhesions by uteroscope who underwent hysteroscopic electrohysterectomy for intrauterine adhesion,and were given intrauterine contraceptive ring,Foley balloon urethral catheter,and self-crosslinking sodium hyaluronate gel after operation.The clinical efficacy of three methods in improvement of menstruation,and prevention of re-adhesion within 3 months were observed.Results The improvement rates of menstruation at 1-3-month were 80.0%(40/50),64.0%(32/50),respectively,in intrauterine contraceptive device group(n=50)78.0%(39/50)58.0%(29/50),respectively,in Foley balloon urethral catheter group(n=50),and 74.0%(37/50),60.0%(30/50),respectively,in the self-crosslinking sodium hyaluronate gel group(n=50).The re-adhesion rates at 1-3-month were 16.0%(8/50)20.0%(10/50),respectively,in intrauterine contraceptive device group18.0%(9/50)24.0%(12/50),respectively,in Foley balloon urethral catheter group,and 20.0%(10/50)24.0%(12/50),respectively,in the self-crosslinking sodium hyaluronate gel group.Conclusion Three methods including intrauterine contraceptive ring,Foley balloon urethral catheter,and self-crosslinking sodium hyaluronategel after hysteroscopic electrohysterectomy have equal efficacy in prevention of short-term re-adhesion and menstruation improvement in patients with severe intrauterine adhesions.