宫腔粘连治疗的研究进展

Research progress in the treatment of intrauterine adhesion

宫腔粘连(IUA)也被称为Asherman综合征,流产刮宫是IUA主要的诱发因素。IUA的特点是当子宫内膜受损时,原本应该进行的正常无瘢痕修复过程被纤维化的修复系统所取代,从而在宫腔内形成纤维粘连带,导致宫腔部分或全部闭塞,已成为女性继发性不孕的主要病因之一。宫腔镜粘连松解术是治疗IUA的传统方法,但具有较高的复发率。间充质干细胞、富血小板血浆宫内灌注治疗可以提高IUA的治疗效果。本文综述间充质干细胞和富血小板血浆宫内灌注治疗IUA研究进展,总结相关机制及上述疗法推广于临床所面临的问题和挑战。

Intrauterine adhesion(IUA),commonly referred to as Asherman syndrome,is primarily triggered by curettage following miscarriage.IUA is characterized by the replacement of the natural,scar-free repair process of the endometrial lining with a fibrotic repair system,resulting in the formation of fibrous adhesions within the uterine cavity,leading to partial or com plete obstruction.The hysteroscopic adhesiolysis has been the conventional approach for treating IUA,but it is associated with a high recurrence rate and suboptimal therapeutic outcomes.Mesenchymal stem cell(MSC)therapy and intrauterine infusion of platelet-rich plasma(PRP)have been shown to enhance the therapeutic outcomes of IUA.This article reviews the research progress in treating IUA with MSC and intrauterine infusion of PRP,summarizes the relevant mechanisms,and discusses the issues and challenges faced in the clinical application of these therapies.