透明质酸钠对瘢痕子宫妊娠患者剖宫产术后宫腔粘连的预防价值研究

Study on the preventive value of sodium hyaluronate on intrauterine adhesions after caesarean section in patients with cicatricial pregnancy

目的:研究透明质酸钠对瘢痕子宫妊娠患者剖宫产术后宫腔粘连的预防价值.方法:选择2020年3月至2022年3月在本院收治的瘢痕子宫妊娠患者(n=70)为研究对象.使用随机数字表法把所有纳入患者分成对照组(n=35)和观察组(n=35).对照组患者术后给予抗生素预防治疗,观察组患者术后给予透明质酸钠预防治疗.对比术后两组患者的月经情况(阴道流血量、阴道出血时间、首次月经恢复时间)、炎性因子水平[C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]、疼痛程度(NRS疼痛评分)、宫腔粘连情况及其他并发症.结果:观察组患者术后阴道流血量、阴道出血时间、首次月经恢复时间均低于对照组(P<0.05).观察组患者术后1 w炎性因子TNF-α、CRP、IL-6水平均低于对照组(P<0.05).观察组术后24 h的NRS评分低于对照组(P<0.05).观察组患者术后宫腔粘连发生率低于对照组(P<0.05).两组患者术后其他并发症差异无统计学意义(P>0.05).结论:透明质酸钠可有效改善瘢痕子宫妊娠患者剖宫产术后月经恢复情况和阴道流血情况,降低炎性因子水平,降低剖宫产术后疼痛感以及宫腔粘连发生率.

Objective:To study the preventive value of sodium hyaluronate on intrauterine adhesions after caesarean section in patients with cicatricial pregnancy.Methods:Patients with scar uterus pregnancy(n=70)admitted to our hospital from March 2020 to March 2022 were selected as the study objects.All patients were divided into control group(n=35)and observation group(n=35)using random number table method.The control group was given postoperative antibiotic prophylactic treatment,and the observation group was given postoperative sodium hyaluronate prophylactic treatment.The menstrual status(amount of vaginal bleeding,time of vaginal bleeding,time of first menstrual recovery),inflammatory factor levels[C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)],pain degree(NRS pain score),uterine adhesion and other complications were compared between the two groups after surgery.Results:Postoperative vaginal bleeding volume,vaginal bleeding time and first menstrual recovery time in observation group were lower than those in control group(P<0.05).The levels of inflammatory factors TNF-α,CRP and IL-6 in observation group were lower than those in control group one week after operation(P<0.05).The NRS score of the observation group was lower than that of the control group at 24 h after operation(P<0.05).The incidence of intrauterine adhesions in observation group was lower than that in control group(P<0.05).There was no significant difference in other postoperative complications between the two groups(P>0.05).Conclusion:Sodium hyaluronate can effectively improve the recovery of menstruation and vaginal bleeding in patients with cicatric pregnancy after cesarean section,reduce the level of inflammatory factors,and reduce the incidence of pain and intrauterine adhesion after cesarean section.