稽留流产术后应用透明质酸钠与戊酸雌二醇对宫腔粘连及子宫恢复效果

The influence of sodium hyaluronate combined with estradiol valerate used after uterine curettage on intrauterine adhesion and uterine recovery of women with missed abortion

目的:探讨稽留流产手术后应用透明质酸钠与戊酸雌二醇治疗宫腔粘连及子宫恢复效果。方法:选取2017年3月-2018年3月在本院行清宫术的稽留流产患者372例,随机数字表法分4组各93例,均实施无痛人流清宫术,术后A组单用透明质酸钠,B组单用戊酸雌二醇,C组联合应用透明质酸钠与戊酸雌二醇,D组不应用任何药物。对比各组术后恢复、不良反应、宫腔粘连发生等。结果:C组的阴道流血时间、腹痛持续时间、月经复潮时间最短,阴道流血总量最少,B组和C组的术后下腹痛、阴道分泌物增多、经量减少发生率均低于A组和D组,宫腔粘连发生率A组最高,C组宫腔粘连程度最轻、A组次之(均P<0.05)。B组和C组有个别患者用药期间出现头晕、恶心、乳房胀痛等不良反应,均症状轻无须处理自行缓解。结论:稽留流产术后联合应用透明质酸钠与戊酸雌二醇能够更有效加快术后子宫内膜修复及月经恢复,预防宫腔粘连,且不良反应较轻,患者可耐受,安全性好。

Objective:To investigate the effect of sodium hyaluronate combined with estradiol valerate for preventing uterine cavity adhesion and improving uterine recovery of women with missed abortion after uterine curettage.Methods:372 women with missed abortion who underwent painless uterine curettage from March 2017 to March 2018 were selected and divided randomly divided into four groups(93 cases in each group)by random numbers table.After uterine curettage,the women in group A were given sodium hyaluronate only,the women in group B were given estradiol valerate only,the women in group C were given sodium hyaluronate combined with estradiol valerate,and the women in group D were not given any drugs.The situation of postoperative recovery and rates of adverse reactions and intrauterine adhesions were compared among the four groups.Results:The duration of vaginal bleeding and abdominal pain,and menstrual recovery time of women in group C were the shortest,and the total amount of vaginal bleeding was the lowest.The incidences of lower abdominal pain,vaginal secretions increased,and menstrual volume decreasing of women in group B and C were significant lower than those of women in group A and D.The incidence of uterine adhesions of women in group A was the highest,but that of women in group C was the lowest(P<0.05).In group B and C,there were several women with adverse reactions such as dizziness,nausea,breast swelling and pain,which all were mild and self relief.Conclusion:Sodium hyaluronate combined with estradiol valerate for treating women with missed abortion after uterine curettage can more effectively accelerate endometrial repaired and menstrual recovery,can prevent uterine adhesions,and has less adverse reactions,which can be tolerated well by women.