球囊支架联合大剂量雌激素预防TCRA术后再粘连的疗效观察

Effect of balloon stent combined with high-dose estrogen on the prevention of re-adhesion after TCRA

目的探讨球囊支架联合大剂量雌激素预防宫腔镜下宫腔粘连分解术(TCRA)术后再粘连的临床疗效。方法选取2016年1月至2019年1月宜都市妇幼保健院妇产科诊治的120例宫腔粘连并行TCRA患者作为研究对象。将这120例患者随机分为球囊支架联合大剂量雌激素组(A组,n=40)、球囊支架联合常规剂量雌激素组(B组,n=40)和大剂量雌激素组(C组,n=40)。比较不同的术后处理方式的治疗效果及对患者月经改善情况的影响。结果A组患者术后1个月、2个月和3个月时月经量较B组患者和C组患者均显著增加,差异均具有统计学意义(均P<0.05)。A组患者术后3个月IUA率显著低于B组患者和C组患者,差异均具有统计学意义(均P<0.05)。A组患者术后3个月临床疗效高于B组患者和C组患者,差异均具有统计学意义(均P<0.05)。结论TCRA术后短期放置球囊支架续用宫内节育器联合口服大剂量雌激素,可促进子宫创面修复,抑制子宫收缩,有效预防IUA再发,临床疗效优于未短期放置球囊支架和口服常规剂量雌激素的患者。

Objective To investigate the clinical effect of balloon stent combined with high dose estrogen in preventing the recurrence of intrauterine adhesions after transcervical resection of adhesion(TCRA).Methods 120 patients with uterine adhesions and received TCRA in Yidu Maternal and Child Health Hospital from January 2016 to January 2019 were selected and randomly divided into balloon stent combined with high dose estrogen group(group A),balloon stent combined with conventional dose estrogen group(group B)and high dose estrogen group(group C),40 cases in each group.The therapeutic effect of different post-operative treatment methods and their effects on menstrual improvement were compared among groups.Results The menstrual volume of group A at 1,2 and 3 months after operation was significantly larger than that of group B and C,with statistically significant differences(all P<0.05).The IUA rate of group A was significantly lower than that of group B and group C at 3 months after operation,with statistically significant differences(all P<0.05).The clinical effect of group A was higher than that of group B and group C at 3 months after operation,with statistically significant differences(all P<0.05).Conclusions Short-term placement of balloon stent and continuous use of intrauterine device combined with oral high-dose estrogen after TCRA can promote the repair of uterine wounds,inhibit uterine contraction and effectively prevent IUA recurrence.The clinical efficacy is better than that of patients without short-term placement of balloon stent and oral conventional dose of estrogen.