透明质酸钠凝胶联用人工周期对中重度宫腔粘连术后的疗效观察

An observation on the effect of sodium hyaluronate gel combined with the artificial cycle on moderate and severe intrauterine adhesions

目的分析中重度宫腔粘连术后给予透明质酸钠凝胶联用人工周期治疗方案的治疗效果。方法回顾宫腔镜手术病例资料,选取因中重度粘连行手术治疗的196例,并根据当时的治疗及预防方案,筛选采用透明质酸钠+人工周期法治疗为治疗组,采用人工周期法治疗为对照组,各98例。2组均治疗2个月经周期后,月经干净3 d复查宫腔镜,比较2组治疗后临床疗效、术后月经来潮时间、AFS评分及再粘连情况。结果干预后,治疗组临床总有效率(96.94%,95/98)优于对照组(90.82%,89/98)(P<0.05);2组手术前后AFS评分各项指标均降低,且治疗组较对照组降低更显著(P<0.05);2组术后第1次月经来潮时间、再粘连发生率比较,差异有统计学意义(P<0.05)。结论宫腔粘连术后宫腔注入透明质酸钠联合人工周期的综合治疗方案能明显提高临床疗效,降低AFS评分,缩短术后月经来潮时间,降低再粘连率。

Objective To analyze the therapeutic effect of the treatment plan with sodium hyaluronate gel combined with the artificial cycle after the operations on the moderate and severe intrauterine adhesions.Methods The case data of hysteroscopic surgeries were reviewed to select the 196 cases of moderate and severe adhesion surgeries.According to their treatment and prevention schemes,patients receiving the treatment of sodium hyaluronate combined with the artificial cycle were selected as the treatment group and those only receiving the artificial cycle as the control group,with 98 cases in each group.Both groups were treated continuously for 2 menstrual cycles,followed by a hysteroscopy three days later after the last menstruation.Their clinical efficacy,postoperative menstruation time,AFS score and re-adhesion were compared.Results After the intervention,the total clinical effective rate of the treatment group(96.94%,95/98)was better than that of the control group(90.82%,89/98)(P<0.05).The AFS scores of the two groups were decreased before and after operation,and the decrease in the treatment group was more significant than that in the control group(P<0.05).The difference in the first menstruation time and the re-adhesion incidence in the two groups was statistically significant(P<0.05).Conclusion The comprehensive treatment scheme of the intrauterine injection of sodium hyaluronate combined with the artificial cycle can significantly improve the clinical efficacy,reduce the AFS score,shorten the menstruation time and reduce the rate of re-adhesion.