聚乳酸防粘连膜联合人工周期疗法预防宫腔镜下宫腔粘连分离术后再粘连的效果分析

Effect Analysis of Polylactic Acid Anti-adhesion Membrane Combined with Artificial Cycle Therapy to Prevent Adhesion after Hysteroscopic Separation of Intrauterine Adhesion

目的 探究聚乳酸防粘连膜联合人工周期疗法预防宫腔镜下宫腔粘连分离术(TCRA)后再粘连的效果。方法 研究对象选取为商丘仁和中医院2019年3月至2021年5月收治的142例宫腔粘连(IUA)患者,所有患者均接受TCRA治疗,将以上患者采用数字表法随机分为观察组、对照组,每组均为71人。对照组患者在TCRA手术治疗后使用人工周期的给药方法实施干预,观察组患者在对照组的基础上,于TCRA手术治疗后给予用聚乳酸凝胶进行干预,人工周期疗法21 d为一个周期,两组患者均连续干预3个周期。比较两组干预后临床疗效,比较两组干预前后子宫内膜厚度、宫腔容积变化情况,并比较两组患者的不良反应发生率和再粘连发生率。结果 观察组治疗有效率为92.96%(66/71),对照组治疗有效率为81.69%(58/71),数据差异有统计学意义(χ^(2)=5.916,P<0.05);干预前两组子宫内膜厚度、宫腔容积数据差异无统计学意义(t=-0.227,-0.095,P>0.05),干预后,两组患者子宫内膜厚度及宫腔容积数据均增高,且观察组子宫内膜厚度、宫腔容积均显著高于对照组,数据差异有统计学意义(t=4.309,4.881,P<0.05);两组不良反应发生率数据差异无统计学意义(χ^(2)=0.624,P>0.05),观察组再粘连发生率低于对照组,数据差异有统计学意义(χ^(2)=5.018,P<0.05)。结论 采用聚乳酸防粘连膜和人工周期疗法相结合的策略预防TCRA术后再粘连,效果较为明确,能够在短期内显著提高疗效,对改善子宫内膜厚度及容积具有一定效果,且具有良好的安全性,值得临床应用。

Objective To explore the effect of polylactic acid anti-adhesion membrane combined with artificial cycle therapy on the prevention of adhesion after hysteroscopic intrauterine adhesion separation(TCRA).Methods A total of 142 patients with intrauterine adhesions(IUA)admitted to Renhe Hospital of Traditional Chinese Medicine in Shangqiu from March 2019 to May 2021 were selected as subjects.All patients received TCRA treatment.The patients were randomly divided into an observation group and a control group by digital table method,with 71 patients in each group.Patients in the control group were treated with artificial cycle administration after TCRA surgery,and patients in the observation group were treated with polylactic acid gel after TCRA surgery on the basis of the control group.The artificial cycle therapy lasted for 21 d,and patients in both groups were treated for 3 consecutive cycles.The clinical efficacy after the intervention was compared between the two groups,and the changes in endometrial thickness and uterine volume before and after intervention were compared between the two groups,and the incidence of adverse reactions and the incidence of adhesion were compared between the two groups.Results The effective rate was 92.96%(66/71)in the observation group and 81.69%(58/71)in the control group,the difference was statistically significant(χ^(2)=5.916,P<0.05).Before the intervention,there was no statistical significance in endometrial thickness and uterine volume data in the two groups(t=-0.227,-0.095,P>0.05).After the intervention,endometrial thickness and uterine volume data increased between the two groups,and the endometrial thickness and uterine volume in the observation group were significantly higher than those in the control group,with statistical significance(t=4.309,4.881,P<0.05);There was no significant difference in the incidence of adverse reactions between the two groups(χ^(2)=0.624,P>0.05),but the incidence of adhesion in the observation group was lower than that in the control group(χ^(2)=5.018,P<0.05).Conclusion The combination of polylactic acid anti-adhesion membrane and artificial cycle therapy to prevent postoperative adhesion of TCRA has a clear effect,which can significantly improve the curative effect in a short term,and has a certain effect on improving endometrial thickness and volume,and has good safety,worthy of clinical application.