仿生物理治疗预防宫腔粘连分离术后再粘连的疗效分析

Efficacy of biomimetic physiotherapy in preventing adhesions after separation of uterine adhesions

目的 探讨仿生物理治疗对于预防宫腔镜下宫腔粘连分离术(TCRA)后宫腔再次粘连以及促进子宫内膜修复生长的疗效.方法 采用前瞻性随机对照研究方法,将2016年1月至2017年5月在湖南省妇幼保健院行宫腔镜下宫腔粘连分离术的92例患者随机分为研究组(45例)和对照组(47例).研究组在TCRA术后给予仿生物电治疗,同时予以人工周期治疗,连续治疗3个月经周期.对照组TCRA术后仅给予激素行人工周期治疗.对比观察两组患者治疗前、治疗1个疗程后月经恢复情况、术后宫腔镜再次检查、排卵期子宫内膜厚度、子宫动脉血流阻力指数(RI)等情况.结果 在1个疗程治疗结束后,研究组治疗有效率和治愈率优于对照组,差异均有统计学意义(P<0.05).研究组治疗后排卵期子宫内膜厚度增加较明显(P<0.05),并且治疗后子宫动脉血流阻力指数明显减低,两组比较差异有统计学意义(P<0.05).结论 仿生物理治疗能够改善盆腔循环,促进子宫内膜生长,在一定程度上预防宫腔粘连分离术后再粘连的形成.

Objective To explore the efficacy of biomimetic physiotherapy in preventing adhesions and promote endometrial repair and growth after Transcervical resection of adhesions ( TCRA) . Methods A prospective case-control study method, from January 2016 to May 2017 in Hunan Maternal and Child Health Hospital underwent TCRA in 92 patients were randomly divided into study (45 cases) and control (47 cases) groups. The patients in the study group were treated with biomimetic therapy after TCRA, and were treated with artificial cycles. Three menstrual cycles were treated continuously. The control group was treated with hormone artificial cycle. The menstrual recovery, ovulation endometrium thickness, uterine ar-tery blood flow resistance index ( RI) and second-look hysteroscopy were observed and compared between two groups before and after 1 course of treatment. Results After 1 course of treatment, the efficiency of the study group was significantly better than that of the control group (P<0. 05), and the cure rate of the study group was significantly higher than that of the control group ( P<0. 05 ) . The endometrial thickness of the study group were increased significantly after ovulation (P<0. 05). The uterine artery blood flow resistance was decreased significantly after treatment in the study group (P<0. 05). Conclusions Bionic physiother-apy can improve pelvic circulation, promote endometrial growth, and prevent the formation of adhesions after TCRA to a certain extent.