两种处理方法治疗中重度宫腔粘连的疗效

Effects of two treatment methods on moderate and severe intrauterine adhesions

目的比较中重度宫腔粘连(IUA)患者宫腔粘连分离术后两种处理方法的疗效差异,找到相对较好的疗法。方法选择2016年10月至2018年10月于杭州市中医院确诊为中重度宫腔粘连的患者120例,宫腔镜粘连分离术后随机分为对照组与试验组,每组各60例。对照组术后宫腔放置宫内节育器和医用几丁糖作为对照组,试验组术后宫腔放置Foley球囊导尿管和医用几丁糖作为试验组。两组患者术后均以激素辅助治疗。定期随访,记录月经量变化、观察宫腔形态是否恢复正常、检查妊娠情况。结果对照组、试验组的月经改善率分别为73.33%、88.33%,差异有统计学意义(P<0.05);宫腔粘连治疗有效率分别为53.33%、85.00%,差异有统计学意义(P<0.05);术后1年妊娠率分别为35.00%、42.86%,差异无统计学意义(P>0.05)。结论中重度IUA患者术后宫腔放置医用几丁糖加Foley球囊在改善术后月经情况和宫腔形态恢复方面的效果优于放置医用几丁糖加节育环。

Objective To compare the effects of two treatment methods used after uterine adhesion separation in patients with moderate to severe intrauterine adhesions(IUA),to find a better treatment.Methods A total of 120 patients diagnosed with moderate to severe intrauterine adhesions in the Hangzhou Hospital of Traditional Chinese Medicine from October 2016 to October 2018 were selected.After hysteroscopic adhesion separation,they were randomly divided into the control group(group A)and the observation group(group B),with 60 patients in each group.The group A were given medical chitosan combined with intrauterine device placement in the uterine cavity after operation as the control group,and the group B were given medical chitosan combined with Foley balloon catheter placement in the uterine cavity after operation as the observation group.Both groups were treated with adjuvant hormone after operation.Regular follow-up was conducted to record the changes in menstrual volume,observe whether the uterine cavity is back to normal,and check the pregnancy status.Results The menstrual improvement rate of the group A and the group B was 73.33%and 88.33%,respectively,with significant difference(P<0.05).The treatment effective rate of intrauterine adhesions was 53.33%and 85.00%,respectively,with significant difference(P<0.05).The 1-year pregnancy rate was 35.00%and 42.86%,respectively,without significant difference(P>0.05).Conclusion The medical chitosan combined with Foley balloon catheter placement in the uterine cavity has better effect than medical chitosan combined with contraceptive ring placement in patients with moderate to severe IUA in terms of improving postoperative menstruation and recovery of uterine cavity shape.