不同方法用于复杂性子宫肌瘤剔除并宫腔成形术后预防子宫腔粘连临床观察

Clinical Observation of Different Methods in Preventing Uterine Cavity Adhesion After Complex Myomectomy and Hysteroplasty

目的探讨宫腔用交联透明质酸钠凝胶与可吸收医用膜应用于复杂性子宫肌瘤剔除并宫腔成形术后预防子宫腔粘连的临床效果。方法选取医院2019年9月至2021年5月行复杂性子宫肌瘤剔除并宫腔成形术的患者108例,随机分为A组(40例)、B组(34例)、C组(34例)。A组患者于宫腔成形术中使用宫腔用交联透明质酸钠凝胶;B组患者于宫腔成形术中使用可吸收医用膜;C组患者术中不做特殊处理。3组患者术后均采用同种抗生素治疗3 d。结果与C组比较,A、B两组患者宫腔粘连程度分级均显著减轻(PAC=0.033,PBC=0.039),宫腔粘连率均显著降低(PAC=0.037,PBC=0.039),经期正常率均显著升高(PAC=0.004,PBC=0.026);痛经程度均显著减轻(PAC=0.010,PBC=0.015)。结论宫腔用交联透明质酸钠凝胶与可吸收医用膜应用于复杂性子宫肌瘤剔除并宫腔成形术后均可减轻患者的宫腔粘连程度,降低宫腔粘连率,提升经期正常率,以及减轻痛经程度。

Objective To investigate the clinical efficacy of cross-linked sodium hyaluronate gel and absorbable medical membrane applied in uterine cavity to prevent uterine cavity adhesion after complex myomectomy and hysteroplasty.Methods From September 2019 to May 2021,108 patients who underwent complex myomectomy and hysteroplasty were randomly divided into group A(40 cases),group B(34 cases)and group C(34 cases).Patients in group A used cross-linked sodium hyaluronate gel for uterine cavity during uterine cavity plasty,patients in group B used absorbable medical membrane during uterine cavity plasty,and patients in group C did not receive special treatment during operation.All patients in the 3 groups were treated with the same antibiotics for 3 d.Results Compared with those in group C,the grade of intrauterine adhesions in groups A and B was significantly lower(PAC=0.033,PBC=0.039),the intrauterine adhesion rate in groups A and B was significantly lower(PAC=0.037,PBC=0.039),the normal rate of menstruation in groups A and B was significantly higher(PAC=0.004,PBC=0.026),while the degree of dysmenorrhea in groups A and B was significantly lower(PAC=0.010,PBC=0.015).Conclusion The application of cross-linked sodium hyaluronate gel and absorbable medical membrane in uterine cavity after complex myomectomy and hysteroplasty can reduce the degree of uterine cavity adhesion,reduce the rate of uterine cavity adhesion,improve the normal rate of menstruation and reduce the degree of dysmenorrhea.