宫腔注入透明质酸钠、戊酸雌二醇及孕激素对宫腔粘连术后再粘连的影响

Effect of intrauterine injection of sodium hyaluronate,estradiol valerate,and progesterone on readhesion after intrauterine adhesion

目的 探讨于患者宫腔内注入透明质酸钠、戊酸雌二醇及孕激素对宫腔粘连术后再粘连情况的预防效果。方法 回顾性分析2017年3月至2018年10月期间在本院经宫腔镜下宫腔粘连术治疗的86例患者,依据上述入院者术后再粘连预防方案的不同分为两组,各43例。对照组采用透明质酸钠,观察组采用透明质酸钠+戊酸雌二醇+孕激素,比较两组宫腔粘连情况、月经量、经期时间以及术后再粘连情况。结果 治疗后,观察组AFS评分为(0.83±0.65)分,低于对照组(1.23±0.71)分,差异有统计学意义(P<0.05);观察组月经量、经期时间分别为(40.21±3.98)ml、(5.21±1.12)d,均高于对照组(37.36±4.09)ml、(4.43±1.16)d,差异均有统计学意义(均P<0.05);观察组术后再粘连率为2.33%,低于对照组16.28%,差异有统计学意义(P<0.05)。结论 宫腔粘连术患者经透明质酸钠、戊酸雌二醇及孕激素联合治疗,效果显著,可有效缓解宫腔粘连程度,改善经期与月经量,利于预防术后再粘连。

Objective To explore the effect intrauterine injection of sodium hyaluronate, estradiol valerate, and progesterone on readhesion after intrauterine adhesion. Methods 86 patients with adhesion surgically treated under hysteroscope at our hospital from March, 2017 to October, 2018 were retrospectively analyzed, and were divided into a control group and an observation group according to different treatment schemes, 43 for each group. The control group were treated with sodium hyaluronate, and the observation group with sodium hyaluronate, estradiol valerate, and progesterone. The conditions of uterine cavity adhesion, the menstruation amount, the menstruation duration, and the readhesion after operation were compared between the two groups. Results After the treatment, the AFS score in the observation group was (0.83 ±0.65), which was lower than that in the control group (1.23 ±0.71), with a statistical difference (P < 0.05). The menstrual volume in the observation group (40.21±3.98) ml, was significantly higher than that in the control group (37.36 ±4.09) ml (P < 0.05). The menstrual duration in the observation group was (5.21±1.12) days, which was significantly longer than that in the control group (4.43±1.16) days (P < 0.05). The postoperative readhesion rate was 2.33% in the observation group, which was lower than that in the control group (16.28%, P < 0.05). Conclusion The combination of sodium hyaluronate, estradiol valerate, and progesterone can effectively relieve the adhesion degree of uterine cavity, improve the amount of menstruation and menorrhoea, and be helpful for the prevention of readhesion after operation.