宫腔粘连电切术后不同方法预防术后再粘连的效果对比

Effect comparison of different methods to prevent post-adhesion after trans-cervical resection of adhesion

目的探讨宫腔粘连电切术后不同种方法预防术后再粘连的效果。方法选取2015年6月~2018年6月我院收治的90例重度宫腔粘连患者作为研究对象,按照随机数字表法分为甲、乙、丙三组,每组各30例。三组均行宫腔粘连电切术,甲组术后放置宫内节育器+口服戊酸雌二醇;乙组术后放置几丁糖+宫内节育器+口服戊酸雌二醇;丙组术后放置几丁糖+COOK球囊支架+口服戊酸雌二醇。于患者术前及治疗3个月后,宫腔镜检查观察粘连情况,记录月经状态。结果术前三组患者的宫腔粘连评分、月经评分比较,差异无统计学意义(P>0.05);术后3个月乙组患者的宫腔粘连评分低于甲组(P<0.05);丙组患者的宫腔粘连评分低于乙组(P<0.05);乙组患者的月经评分低于甲组(P<0.05);丙组患者的月经评分低于乙组(P<0.05)。结论宫腔粘连患者术后应用COOK球囊联合几丁糖、口服戊酸雌二醇可有效预防术后宫腔粘连,改善月经状态,临床效果显著,值得临床推广应用。

Objective To analyze the effect of different methods to prevent post-adhesion after intrauterine adhesions.Methods Ninety patients with severe intrauterine adhesions admitted to our hospital from June 2015 to June 2018 were selected as subjects,and divided into groups A,B and C according to the random number table method,with 30 cases in each group.In all three groups,intrauterine adhesions were performed,and intrauterine device + oral Estradiol Valerate was placed in group A.Group B was placed with chitosan + intrauterine device + oral Estradiol Valerate after surgery.And the Chitosan + COOK balloon stent + oral Estradiol Valerate was placed in group C.Before the operation and 3 months after the operation,hysteroscopy was performed to observe the adhesion and the menstrual status was recorded.Results There was no significant difference in the intrauterine adhesion score and menstrual score between the three groups before operation (P>0.05).The postoperative adhesion score of group B was lower than that of group A (P<0.05).The intrauterine adhesion score was lower in group than in group B (P<0.05).The menstrual score of group B was lower than that of group A (P<0.05).The menstrual score of group C was lower than that of group B (P<0.05).Conclusion The application of COOK balloon combined with Chitosan and oral Estradiol Valerate in patients with intrauterine adhesions can effectively prevent postoperative intrauterine adhesions and improve menstrual status.The clinical effect is significant and worthy of clinical application.