脱花煎封包外敷联合宫腔用交联透明质酸钠凝胶预防人工流产术后宫腔粘连临床研究

Clinical Study of External Application of Tuohua Jian Package Combined with Crosslinked Sodium Hyaluronate Gel for Uterine Cavity in Prevention of Intrauterine Adhesion After Induced Abortion Operation

目的:观察脱花煎封包外敷联合宫腔用交联透明质酸钠凝胶对人工流产术后宫腔粘连(IUA)的预防效果。方法:选取110例人工流产术后患者,按随机数字表法分为对照组和治疗组各55例。对照组术后给予常规抗感染及热敷治疗,治疗组在对照组基础上给予脱花煎封包外敷联合宫腔用交联透明质酸钠凝胶治疗。比较2组术后当天及术后1周疼痛程度、术后阴道流血时间、术后首次月经来潮时间及IUA发生率。结果:术后1周,治疗组视觉模拟评分法(VAS)评分低于对照组(P<0.05)。治疗组术后阴道流血时间≤7 d占比大于对照组(P<0.05);2组术后阴道流血时间8~14 d及>14 d占比比较,差异均无统计学意义(P>0.05)。治疗组术后阴道流血时间、首次月经来潮时间均短于对照组(P<0.05)。术后3个月,治疗组IUA发生率为1.82%,对照组IUA发生率为14.55%,2组比较,差异有统计学意义(P<0.05)。结论:脱花煎封包外敷联合宫腔用交联透明质酸钠凝胶可以有效预防人工流产术后IUA,缓解术后疼痛,缩短阴道流血时间。

Objective:To observe the effect of external application of Tuohua Jian package combined with crosslinked sodium hyaluronate gel for uterine cavity in the prevention of intrauterine adhesion(IUA)after induced abortion operation.Methods:A total of 110 cases of patients after induced abortion operation were selected and divided into the control group and the treatment group according to the random number table method,55 cases in each group.After operation,the control group was given routine anti-infection treatment and hot compress,and the treatment group was additionally given external application of Tuohua Jian package combined with crosslinked sodium hyaluronate gel for uterine cavity based on the treatment of the control group.The degree of postoperative pain after operation and one week after operation,the duration of postoperative virginal bleeding,the first menstruation after operation and the incidence of IUA were compared between the two groups.Results:The score of Visual Analog Scale(VAS)one week after operation in the treatment group was lower than that in the control group(P<0.05).The proportions of patients with a postoperative vaginal bleeding time≤7 days in the treatment group was larger than that in the control group(P<0.05);there were no significant difference being found when compared the proportion of patients with a postoperative vaginal bleeding time lasting 8 to 14 days and apostoperative virginal bleeding time>14 days between the two groups(P>0.05).When compared with those in the control group,in the treatment group,the duration of postoperative virginal bleeding was shorter,and the first menstruation after operation was earlier(P<0.05).During the first three months after operation,the incidence of IUA was 1.82%in the treatment group and 14.55%in the control group,the difference being significant(P<0.05).Conclusion:The therapy of external application of Tuohua Jian package combined with crosslinked sodium hyaluronate gel for uterine cavity can effectively prevent IUA after induced abortion operation,relieve postoperative pain,and shorten virginal bleeding time.