不同预防方案对宫腔镜下宫腔粘连分离术疗效的影响

Effect of different prevention regimens on the efficacy of transcervical resection of adhesion

目的分析不同预防方案对宫腔镜下宫腔粘连分离术疗效的影响。方法选取2013年1月至2017年7月于本院行宫腔镜下粘连分离术的患者220例,将术后宫腔内留置球囊导尿管并注入几丁糖者纳入A组(110例),术后置入宫内节育器者纳入B组(110例)。比较两组患者术后宫腔粘连情况、疗效、子宫内膜厚度、妊娠情况。结果术后6个月,A组患者再粘连率显著低于B组(χ^2=8.658,P=0.003),治愈率显著高于B组(P<0.05),但两组患者治疗总有效率比较差异无显著性(P>0.05)。术后3个月、6个月,两组患者子宫内膜厚度均较术前显著增厚(均P<0.05),但A组患者子宫内膜厚度显著大于B组(均P<0.05)。随访1年,A组患者妊娠率显著高于B组(χ^2=5.387,P=0.020)。结论宫腔镜粘连分离术后放置球囊导尿管并注入几丁糖可有效预防术后再粘连的发生,提高手术疗效,值得临床推广应用。

Objective To explore the effect of different prevention programs on the efficacy of transcervical resection of adhesion. Method A total of 220 patients with transcervical resection of adhesion in our hospital from January 2013 to July 2017 were enrolled.The patients who underwent intrauterine indwelling balloon catheter and injected with chitosan were included in group A (110 cases),and those who received intrauterine device after operation were included in group B ( 110 cases).The postoperative intrauterine adhesions,therapeutic efficacy,endometrial thickness,and pregnancy were compared between the two groups.Result At 6 months after surgery,the re-adhesion rate of group A was significantly lower than that of group B (χ^2 = 8.658,P = 0.003),the cure rate was significantly higher than that of group B (P < 0.05),but there was no significant difference in the total effective rate between the two groups (P > 0.05).3 months and 6 months after operation,the thickness of endometrium in the two groups were significantly thicker than those before operation (all P < 0.05),but the endometrial thickness of group A were significantly higher than those of group B (all P < 0.05).After 1 year of follow-up,the pregnancy rate of group A was significantly higher than that of group B (χ^2 = 5.387,P = 0.020).Conclusion Placement of balloon catheter and injecting chitosan after transcervical resection of adhesion can effectively prevent postoperative re-adhesion,improve surgical outcome,and is worthy of clinical application.