联合应用几丁糖、球囊支架在预防重度宫腔粘连术后再粘连的效果分析

Analysis of the effect of readhesion of Combined application of chitosan and balloon stent in the prevention of severe intrauterine adhesions

目的:探讨宫腔粘连电切术后3种方法预防术后再粘连的疗效。方法:91例重度宫腔粘连患者,根据术后处理方法随机分成3组,91例患者均行B超监护下宫腔镜下宫腔粘连电切术,A组术后放置宫内节育器+口服戊酸雌二醇。B组术后放置几丁糖+宫内节育器+口服戊酸雌二醇。C组术后放置几丁糖+COOK球囊支架+口服戊酸雌二醇。术后3个月评估月经改善情况,并行二次宫腔镜检查评估宫腔粘连改善情况。结果:从宫腔粘连及月经改善情况两个维度进行比较,C组有效率高于B组,B组有效率高于A组,C组有效率高于A组,宫腔粘连改善总有效率方差分析(F=3.612,P=0.032),月经改善总有效率秩和检验比较(χ~2=8.984,P=0.029)。组间比较差异有统计学意义。结论:TCRA术后联合应用几丁糖、球囊支架可更加有效地预防重度宫腔粘连术后再粘连的发生。

Objective:To investigate the effect of 3 methods of postoperative adhesion in patients with severeintrauterine adhesions.Methods:91 cases of severe intrauterine adhesions in patients,according to the operation method of postprocessing were randomly divided into 3 groups,91 patients underwent hysteroscopy under B-ultrasound monitoring uterine cavity adhesion electrocision. Group A after IUD + oral estradiol valerate. Group B after placement of chitosan + intrauterine device + oral estradiol valerate. Group C was placed with chitosan +COOK balloon stent + oral estradiol valerate. 3 months after the evaluation period to improve the situation,parallel two hysteroscopy to assess the improvement of uterine cavity adhesion. Results:From two dimensions of intrauterine adhesions and menstrual improvement,the total effective rate of group C was higher than that of group B,the total effective rate of group B was higher than that of group A,the total effective rate of group C was higher than that of group A. intrauterine adhesions total effective rate used variance analysis(F=3.612,P=0.032);Menstruation to improve total effective comparison used rank sum test(χ~2=8.984,P=0.029).The difference was statistically significant(P<0.05). Conclusion:The combined application of chitosan and balloon stent can prevent the recurrence of severe intrauterine adhesion after TCRA operation.