宫腔镜分离粘连手术治疗不同程度宫腔粘连的效果观察

Effect of hysteroscopic separation of adhesions on the treatment of different degrees of intrauterine adhesions

目的观察宫腔镜分离粘连手术对于不同程度宫腔粘连患者的治疗效果。方法选取46例宫腔粘连患者,根据宫腔粘连累及宫腔范围不同分为A组(范围1/3~2/3)与B组(范围2/3以上),每组23例。两组均采取宫腔镜分离粘连手术治疗,观察对比两组患者治疗前后宫腔粘连情况、月经量、子宫体积、子宫内膜厚度及临床疗效。结果治疗前,两组宫腔粘连评分、月经量、子宫体积及子宫内膜厚度比较,差异无统计学意义(P>0.05);治疗后,A组宫腔粘连评分显著低于B组,月经量多于B组,子宫体积和子宫内膜厚度显著高于B组,差异具有统计学意义(P<0.05)。A组患者治疗总有效率为95.65%,明显高于B组的73.91%,差异具有统计学意义(P<0.05)。结论宫腔镜分离粘连手术对不同程度宫腔粘连患者的治疗效果不同。宫腔粘连程度越严重,对患者的宫腔分离及月经量、子宫的体积、子宫内膜的厚度恢复就越困难,治疗效果越差。

Objective To observe the therapeutic effect of hysteroscopic separation of adhesions on patients with different degrees of intrauterine adhesions.Methods 46 patients with intrauterine adhesion were selected and divided into group A(range 1/3 to 2/3)and group B(range more than 2/3)according to the intrauterine adhesion to the intrauterine range,23 cases in each group.Both groups were treated with hysteroscopic adhesions separation surgery.The intrauterine adhesions,menstrual volume,uterine volume,endometrial thickness and clinical efficacy before and after treatment were observed and compared between the two groups.Results Before treatment,there were no significant differences in intrauterme adhesion score,menstrual volume,uterine volume and endometrial thickness between the two groups(P>0.05).After treatment,the intrauterme adhesion score of group A was significantly lower than that of group B,the menstrual volume was more than that of group B,the uterine volume and endometrial thickness were significantly higher than those of group B,and the differences were statistically significant(P>0.05).The total effective rate of group A was 95.65%,which was significantly higher than that of group B 73.91%(P<0.05).Conclusion Hysteroscopic adhesions separation surgery has different therapeutic effects on patients with different degrees of intrauterine adhesions.The results of this study show that the more severe the uterine cavity adhesion,the more difficult it is to recover the uterine cavity separation,menstrual volume,uterine volume and endometrial thickness,and the worse the treatment effect.