经球囊扩张术联合屈螺酮炔雌醇片治疗人工流产术后宫腔轻中度粘连的临床疗效

Clinical efficacy of balloon dilatation combined with pirospirone ethinylestradiol tablets in the treatment of mild and moderate intrauterine adhesions after abortion

目的探究经球囊扩张术联合屈螺酮炔雌醇片治疗人工流产术后宫腔轻中度粘连的临床效果。方法前瞻性分析2017年9月至2020年1月新疆医科大学第二附属医院收治的60例人工流产手术后并发轻中度宫腔粘连患者的临床资料,按照随机数字表法分为对照组(n=30)和观察组(n=30)。对照组患者单纯给予屈螺酮炔雌醇片治疗,观察组患者在对照组基础上联合经球囊扩张术治疗。比较2组患者术后宫腔粘连的治疗效果、宫腔粘连程度、子宫内膜血流指标[包括血管化指数(VI)、血流指数(FI)、血管血流指数(VFI)]、子宫内膜厚度。结果观察组总有效率(90.00%)明显高于对照组(73.33%),差异有统计学意义(P<0.05)。观察组治疗后美国生育协会(AFS)评分(0.65±0.06)分,明显低于对照组的(1.72±0.09)分,差异有统计学意义(P<0.05)。观察组治疗后子宫内膜厚度、VI、FI、VFI分别为(6.12±0.28)mm、3.83±0.36、27.19±1.08、2.88±0.16,分别高于对照组的(5.13±0.25)mm、2.92±0.35、21.38±1.05、1.72±0.14,差异均有统计学意义(P<0.05)。结论与单纯给予屈螺酮炔雌醇片治疗相比,经球囊扩张术联合屈螺酮炔雌醇片治疗人工流产术后轻中度宫腔粘连能取得更为满意的治疗效果,有助于减轻宫腔粘连程度,改善子宫内膜血液循环,利于子宫内膜发育。

Objective To explore the therapeutic effect of balloon dilatation combined with pirospirone ethinylestradol tablets in the treatment of mild and moderate intrauterine adhesions after abortion.Methods A prospective analysis of the clinical data of 60 patients with mild to moderate intrauterine adhesions after artificial abortion,who were admitted to the Second Affiliated Hospital of Xinjiang Medical University from September 2017 to January 2020,were divided into control groups according to the randomization method(n=30)and the observation group(n=30).The control group was treated with drospirenone and ethinyl estradiol tablets alone,and the observation group was treated with balloon dilatation based on the control group.To compare the therapeutic effects of postoperative intrauterine adhesions,the degree of intrauterine adhesions,and endometrial blood flow indexes[including vascularization index(VI),blood flow index(FI),vascular blood flow index(VFI)],Endometrial thickness.Results The total effective rate(90.00%)of the observation group was significantly higher than that of the control group(73.33%),and the difference was significant(P<0.05).The AFS score(0.65±0.06)of the observation group after treatment was significantly lower than that of the control group(1.72±0.09),and the difference was significant(P<0.05).The endometrial thickness,VI,FI,and VFI of the observation group after treatment were(6.12±0.28)mm,3.83±0.36,27.19±1.08,2.88±0.16,respectively,which were higher than those of the control group(5.13±0.25)mm,2.92±0.35,21.38±1.05,1.72±0.14,the differences were all significant(P<0.05).Conclusion Compared with the treatment with drospirenone and ethinyl estradiol tablets alone,balloon dilatation combined with drospirenone and ethinyl estradiol tablets for the treatment of mild to moderate intrauterine adhesions after artificial abortion can achieve a more satisfactory therapeutic effect,which is helpful To reduce the degree of intrauterine adhesions,improve the blood circulation of the endometrium,and facilitate the development of the endometrium.