高剂量雌孕激素序贯辅助宫腔镜手术治疗重度子宫腔粘连的效果

Effect of High-dose Sequential Estrogen and Progesterone Assisted Hysteroscopy in the Treatment of Severe Intrauterine Adhesion

目的:探析重度子宫腔粘连患者采用高剂量雌孕激素序贯辅助宫腔镜手术治疗的临床效果。方法:2020年5月—2023年1月抽选乳山市中医院收治的86例重度子宫腔粘连患者,采用随机数字表法分为观察组(n=43)、对照组(n=43)。两组患者均行宫腔镜下宫腔粘连分离术治疗,对照组患者术后行低剂量雌孕激素序贯治疗,观察组患者术后行高剂量雌孕激素序贯治疗。比较两组子宫内膜厚度、子宫体积、性激素水平、生活质量评分、宫腔再粘连发生率。结果:治疗后观察组子宫内膜厚度、子宫体积均大于对照组,差异均有统计学意义(P<0.05);治疗后观察组性激素水平均高于对照组,差异均有统计学意义(P<0.05);治疗后观察组生活质量评分均高于对照组,差异均有统计学意义(P<0.05);观察组宫腔再粘连发生率低于对照组,差异有统计学意义(P<0.05)。结论:重度子宫腔粘连患者采用高剂量雌孕激素序贯辅助宫腔镜治疗可增加子宫内膜厚度及子宫体积,改善性激素水平,提高生活质量,降低宫腔再粘连发生率。

Objective:To explore the clinical effect of high-dose sequential estrogen and progesterone assisted hysteroscopy in patients with severe intrauterine adhesion.Method:A total of 86 patients with severe intrauterine adhesion admitted to Rushan City Hospital of Traditional Chinese Medicine from May 2020 to January 2023 were selected and divided into observation group(n=43)and control group(n=43)according to random number table method.Patients in both groups were treated with hysteroscopic adhesiolysis of intrauterine adhesion.Patients in the control group were treated with low-dose sequential estrogen and progesterone and patients in the observation group were treated with high-dose sequential estrogen and progesterone.Endometrial thickness,uterine volume,sex hormone level,quality of life score and incidence of intrauterine readhesion were compared between the two groups.Result:After treatment,endometrial thickness and uterine volume in observation group were higher than those in control group,the differences were statistically significant(P<0.05).After treatment,the sex hormone levels in observation group were higher than those in control group,the differences were statistically significant(P<0.05).After treatment,the quality of life scores of observation group were higher than those of control group,the differences were statistically significant(P<0.05).The incidence of intrauterine readhesion in observation group was lower than that in control group,the difference was statistically significant(P<0.05).Conclusion:High-dose sequential estrogen and progesterone assisted hysteroscopy in patients with severe intrauterine adhesion can increase endometrial thickness and uterine volume,improve sex hormone levels,improve quality of life,and reduce the incidence of intrauterine readhesion.