宫腔镜松解术联合芬吗通治疗重度宫腔粘连对子宫内膜的影响

Effect of Hysteroscopy Combined with Femoston on Endometrium in the Treatment of Severe Intrauterine Adhesions

目的:探讨宫腔镜松解术联合芬吗通治疗重度宫腔粘连对子宫内膜的影响。方法:选择2017年1月-2018年1月本院收治的重度宫腔粘连患者52例,随机分为对照组和研究组,每组26例。两组患者均行宫腔镜松解术,术后对照组采用补佳乐药物治疗,研究组采用芬吗通药物治疗。比较两组患者子宫内膜厚度、月经改善、妊娠及妊娠结局、不良反应发生等情况。结果:治疗后15 d、1个月、2个月,研究组患者子宫内膜厚度均大于对照组,差异均有统计学意义(P<0.05);研究组月经恢复总有效率为88.5%,高于对照组的53.8%,差异有统计学意义(P<0.05);治疗后,研究组月经量多于对照组,行经时间长于对照组,足月分娩率及活胎率均高于对照组,再次粘连率低于对照组,差异均有统计学意义(P<0.05);两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论:宫腔镜松解术联合芬吗通治疗重度宫腔粘连,患者子宫内膜状态和月经改善效果更佳,早期妊娠率明显提高,能够促进子宫内膜修复,术后预防再粘连效果较好,且具有较好的安全性,临床应用价值较高。

Objective:To investigate the effect of hysteroscopy combined with Femoston in the treatment of severe intrauterine adhesion on endometrium.Method:A total of 52 patients with severe intrauterine adhesion admitted to our hospital from January 2017 to January 2018 were selected.There were randomly divided into control group and study group,26 cases in each group.Both groups underwent hysteroscopic lysis,after operation,the control group was given Bujiale drug treatment,the study group was treated with Femoston.The endometrial thickness,menstrual improvement,pregnancy and pregnancy outcome and adverse reactions were compared between the two groups.Result:15 days,1 month,2 months after treatment,the endometrial thickness in the study group were greater than those in the control group,the differences were statistically significant (P<0.05).The total rate of menstrual recovery in the study group was 88.5%,higher than the 53.8% in the control group,the difference was statistically significant (P<0.05).After treatment,the study group had more menstrual flow than the control group,menstrual period longer than the control group,the rate of full-term delivery and the rate of live birth were higher than the control group,the rate of re-adhesion was lower than the control group,the differences were statistically significant (P<0.05).Comparison of the total incidence of adverse reactions between the two groups,the difference was not statistically significant (P>0.05).Conclusion:Hysteroscopy combined with fimutong for the treatment of severe intrauterine adhesions can improve the endometrium status and menstruation of the patients better,significantly improve the rate of early pregnancy,can promote the repair of endometrium,postoperative prevention of re-adhesions is better,has good safety,high clinical application value.