宫腔镜下宫腔粘连分离术联合大剂量雌激素在治疗中重度宫腔粘连中的临床效果观察

Clinical effect observation of hysteroscopic separation of transcervical resection of adhesions combined with high-dose of estrogen in the treatment of moderate and severe intrauterine adhesions

目的分析宫腔镜下宫腔粘连分离术(TCRA)联合大剂量雌激素治疗中重度宫腔粘连的临床效果。方法选取76例中重度宫腔粘连患者为研究对象,依据随机数字表法分为小剂量组与大剂量组,各38例。小剂量组予以TCRA联合戊酸雌二醇片口服,1mg/次,1次/d;大剂量组予以TCRA联合戊酸雌二醇片口服,2mg/次,2次/d,持续干预3个月。术后3个月统一评价两组的临床疗效,术前及术后3个月评价两组的子宫形态(子宫体积)和子宫内膜厚度。结果大剂量组的总有效率高于小剂量组(P<0.05)。两组术前的子宫体积和子宫内膜厚度比较,差异无统计学意义(P>0.05)。两组术后3个月的子宫体积和子宫内膜厚度均增加(P<0.05);大剂量组术后3个月的子宫体积和子宫内膜厚度均高于小剂量组(P<0.05)。结论TCRA联合大剂量雌激素可以进一步提高中重度宫腔粘连的临床效果,改善子宫形态,促进子宫内膜的早期恢复。

Objective To analyze the clinical effect of hysteroscopic separation of transcervical resection of adhesions(TCRA)combined with high-dose estrogen in the treatment of moderate and severe intrauterine adhesions.Methods A total of 76 patients with moderate and severe intrauterine adhesions were selected as the study subjects,they were divided into the low-dose group and the high-dose group according to the random number table method,38 cases in the each group.The low-dose group was given TCRA combined with estradiol valerate orally,1 mg/time,once a day.The high-dose group was given TCRA combined with estradiol valerate orally,2 mg/time,twice a day,and the intervention lasted for three months.The clinical efficacy of the two groups was evaluated uniformly at 3 months after surgery,and the uterine morphology(uterine volume)and endometrial thickness of the two groups were evaluated before and 3 months after surgery.Results The total effective rate of the high-dose group was higher than that of the low-dose group(P<0.05).There were no statistical significances in the preoperative uterine volume and endometrial thickness between the two groups(P>0.05).At 3 months after operation,the uterine volume and endometrial thickness of the two groups increased(P<0.05),and the uterine volume and endometrial thickness of the high-dose group were higher than those of the low-dose group(P<0.05).Conclusion TCRA combined with high-dose estrogen can further improve the clinical effect of moderate and severe uterine adhesions,improve uterine morphology,and promote the early recovery of endometrium.