子宫球囊支架联合宫腔用交联透明质酸钠凝胶防治中重度宫腔粘连分离术后再粘连及对患者预后影响研究

Uterine Balloon Stent Combined with Intrauterine Crosslinked Sodium Hyaluronate Gel for the Prevention and Treatment of Moderate and Severe Intrauterine Adhesions Readhesion after Separation and its Influence on the Prognosis of Patients

目的 研究子宫球囊支架联合宫腔用交联透明质酸钠凝胶防治中重度宫腔粘连分离术后再粘连及对患者预后质量的影响。方法 选择2019年3月-2021年3月在东莞康华医院确诊的78例中重度宫腔粘连患者作为研究对象,依据其入院时间将2019年3月-2020年3月入院的39例患者纳入对照组,将2020年4月-2021年3月入院的39例患者纳入观察组,两组患者均行宫腔镜下粘连分离术,对照组术后于宫腔内置入“O”型带尾丝节育器,观察组术后于宫腔内注射宫腔用交联透明质酸钠凝胶,并将子宫球囊支架置入宫腔。比较两组宫腔粘连患者治疗后内膜厚度、宫腔形态及月经改善情况。结果 观察组子宫内膜厚度、宫腔形态恢复均优于对照组,月经模式评分较对照组低(P <0.05)。结论 对中重度宫腔粘连患者应用子宫球囊支架联合宫腔用交联透明质酸钠凝胶治疗可起到显著的宫腔粘连分离术后再粘连防治效果并改善其预后。

Objective To investigate the effect of uterine balloon stent combined with intrauterine crosslinked sodium hyaluronate gel on the prevention and treatment of readhesion after moderate and severe intrauterine adhesions separation and the prognosis quality of patients. Methods 78 patients with moderate to severe intrauterine adhesions confirmed by examination in our hospital from March 2019 to March 2021 were selected as the study subjects. According to their admission time, 39 patients admitted from March 2019 to March 2020 were included in the control group, and 39 patients admitted from April 2020 to March 2021 were included in the observation group. The two groups of patients underwent hysteroscopic adhesion separation. The control group was implanted with an “O” type tail wire IUD in the intrauterine cavity after surgery, while the observation group was injected with intrauterine crosslinked sodium hyaluronate gel and implanted with uterine balloon stent. The endometrial thickness,endometrial morphology and menstrual improvement of patients with intrauterine adhesion were compared between the two groups. Results The endometrial thickness and endometrial morphology of the observation group were better than that of the control group, and the score of menstrual pattern was lower than that of the control group(P <0.05). Conclusion Uterine balloon stent combined with crosslinked sodium hyaluronate gel can significantly improve the prognosis of patients with moderate and severe intrauterine adhesions after intrauterine adhesions separation.