宫腔粘连分离术中放置宫内节育器联合雌激素治疗效果

Efficacy of intrauterine device inserted during operation of adhesion separation combined with estrogen for treating women with intrauterine adhesion

目的:探究宫腔粘连(IUA)分离术中应用宫内节育器(IUD)和激素治疗效果及对患者雌二醇(E2)、黄体生成素(LH)影响。方法:选取2017年1月—2020年1月本院收治的IUA患者120例,随机分为观察组、E2组和IUD组各40例。所有患者均行IUA分离术,E2组采用单纯雌激素治疗,IUD组单纯放置IUD治疗,观察组采用雌激素加放置IUD治疗,对比3组临床疗效、血清E2和LH水平等。结果:观察组临床有效率(90.0%)、月经改善率(95.0%)高于E2组(80%、77.5%)和IUD组(80%、72.5%),术后再粘连发生率(20.0%)低于E2组(40.0%)和IUD组(27.5%)(P<0.05)。治疗后3组血清雌二醇(E2)、促黄体生成素(LH)水平均比治疗前降低,且观察组降低幅度大于另外两组(P<0.05)。结论:在IUA分离术中应用IUD联合雌激素治疗可提高临床治疗效果,有效降低患者术后血清E2、LH水平,有助于改善月经,降低术后再粘连发生风险且不增加并发症。

Objective:To explore the efficacy of intrauterine device(IUD)inserted during the operation of adhesion separation combined with estrogen for treating women with intrauterine adhesion(IUA),and to study its influence on their estradiol(E2)and Luteinizing hormone(LH)levels.Methods:120 women with IUA were selected and divided into group A,group B and group C(40 cases in each group)from January 2017 to January 2020.All the women in the three groups were given IUA separation operation,then the women in group B were treated with estrogen alone,the women in group C were inserted IUD,and the women in group A were treated with estrogen combined with IUD.The clinical treatment effect,and serum E2 and LH levels of the women were compared among the three groups.Results:The clinical effective rate(90.0%)and menstrual improvement rate(95.0%)of the women in group A were significant higher than those(80%and 77.5%)of the women in group B and those(80%and 72.5%)of the women in group C.The incidence of postoperative re-adhesion(20.0%)of the women in group A was significant lower than that(40.0%)of the women in group B and that(27.5%)of the women in group C(P<0.05).After treatment,the serum levels of E2 and LH of the women in the three groups had decreased significantly,and which of the women in group A were significant lower than those of the women the other two groups(P<0.05).Conclusion:The application of IUD inserted during operation of adhesion separation combined with estrogen for treating women with IUA can improve the clinical effect,reduce their serum E2 and LH levels effectively,which is conducive to the improvement of menstruation status,reduce the risk of postoperative re-adhesion without increasing the risk of complications,so it is worthy of clinical application.