用三种措施预防进行宫腔镜下宫腔粘连分离术的患者发生术后再粘连的疗效

Three measures to prevent postoperative readhesion in patients undergoing hysteroscopic separation of intrauterine adhesions

目的:观察用三种措施预防接受宫腔镜下宫腔粘连分离术的患者发生术后再粘连的临床效果。方法:选取2020年8月至2021年6月期间在德江县人民医院接受宫腔镜下宫腔粘连分离术的96例宫腔粘连患者为研究对象。按照治疗方法的不同将其分为A组(n=30)、B组(n=32)和C组(n=34)。术后,用雌激素、孕激素对三组患者进行治疗。在此基础上,为A组患者放置宫内节育器,为B组患者向宫腔内注射医用透明质酸钠,为C组患者放置宫内节育器并向宫腔内注射医用透明质酸钠。治疗后,对比三组患者月经的恢复情况、宫腔再粘连的发生情况及术后的妊娠情况。结果:治疗前,三组患者月经恢复情况的评分相比,P>0.05。治疗后,三组患者月经恢复情况的评分均低于治疗前,其中C组患者月经恢复情况的评分均低于A组及B组患者,P<0.05。治疗后,C组患者宫腔再粘连的总发生率均低于A组及B组患者,P<0.05。术后,三组患者中妊娠成功患者的占比相比,P>0.05。结论:为接受宫腔镜下宫腔粘连分离术的患者在应用雌激素、孕激素的同时放置宫内节育器、向宫腔内注射医用透明质酸不会提高其术后妊娠的成功率,但可促进其月经的恢复,降低其术后宫腔再粘连的发生率。

Objective:To observe the clinical effect of three measures to prevent postoperative readhesion in patients undergoing hysteroscopic separation of intrauterine adhesions.Methods:A total of 96 patients with intrauterine adhesion who received hysteroscopic separation of intrauterine adhesion in Dejiang County People’s Hospital from August 2020 to June 2021 were selected as the study subjects.They were divided into group A(n=30),group B(n=32)and group C(n=34)according to different treatment methods.After operation,the three groups were treated with estrogen and progesterone.On this basis,iUD was placed in group A,medical sodium hyaluronate was injected into intrauterine cavity for group B,and iUD was placed and medical sodium hyaluronate was injected into intrauterine cavity for group C.After treatment,the recovery of menstruation,the occurrence of intrauterine readhesion and postoperative pregnancy of the three groups were compared.Results:Before treatment,the score of menstrual recovery in the three groups was compared,P>0.05.After treatment,the scores of menstrual recovery in the three groups were all lower than before treatment,and the scores of menstrual recovery in group C were all lower than those in group A and B,P<0.05.After treatment,the total incidence of intrauterine readhesion in group C was lower than that in group A and B,P<0.05.After surgery,the proportion of successful pregnancy patients in the three groups was compared,P>0.05.Conclusion:For patients undergoing hysteroscopic separation of intrauterine adhesions,placing intrauterine device and injecting medical hyaluronic acid into the intrauterine while applying estrogen and progesterone will not improve the success rate of postoperative pregnancy,but can promote the recovery o f menstruation and reduce the incidence of postoperative intrauterine adhesions.