本文選題：宮腔粘連 + 預防��； 參考：《廣西醫(yī)科大學》2017年碩士論文

【摘要】：目的:通過收集宮腔粘連患者的臨床資料,比較三種不同治療方法的療效,探討宮腔鏡下宮腔粘連分離術后預防再粘連的治療方法。方法:回顧性分析2015年1月~2016年11月廣西醫(yī)科大學第一附屬醫(yī)院計劃生育科收治的103例在宮腔鏡下證實為宮腔粘連患者的臨床資料,按宮腔鏡下宮腔粘連分離術后預防再粘連治療方法的不同分為A組(46例)、B組(34例)和C組(23例)。A組為節(jié)育環(huán)(IUD)+雌孕激素序貫治療,B組為IUD+宮腔灌注粒細胞刺激因子(G-CSF)+雌孕激素序貫治療,C組為Foley球囊+宮腔灌注G-CSF+雌孕激素序貫治療。三組病人術后均在宮腔內(nèi)保留透明質(zhì)酸凝膠3-5ml。在術后第3個月返院行宮腔鏡二次探查術,并記錄宮腔重構(gòu)情況、子宮內(nèi)膜厚度、月經(jīng)恢復情況等。三個月后則通過電話隨防患者妊娠情況。所有的數(shù)據(jù)采用SPSS 22.0進行統(tǒng)計學處理。結(jié)果:1、患者的一般資料(年齡、人流次數(shù)、體重、孕次、宮腔操作次數(shù)、發(fā)病時間、術前子宮內(nèi)膜厚度、宮腔粘連程度、就診原因)對比差異無統(tǒng)計學意義(P0.05)。2、在宮腔鏡下宮腔粘連分離術后治療有效率、宮腔重構(gòu)有效率、妊娠率三組間比較差異均無統(tǒng)計學意義(p0.05)。結(jié)論:宮腔鏡下宮腔粘連分離術后,留置IUD、留置IUD+宮腔灌注GCSF、留置Foley球囊+宮腔灌注G-CSF,同時輔以雌孕激素序貫治療和透明質(zhì)酸鈉治療均能有效預防宮腔再粘連,且在治療有效率、宮腔重構(gòu)有效率、妊娠率上比較無明顯差異。
[Abstract]:Objective: to collect the clinical data of patients with intrauterine adhesions and to compare the curative effects of three different treatment methods and to explore the treatment methods of preventing readhesions after hysteroscopic separation of intrauterine adhesions.Methods: the clinical data of 103 patients with intrauterine adhesion confirmed by hysteroscopy were analyzed retrospectively from January 2015 to November 2016 in the Family Planning Department of the first affiliated Hospital of Guangxi Medical University.According to the different methods of preventing and treating readhesion after hysteroscopy, the patients were divided into two groups: group A (n = 46) and group C (n = 23). Group A (n = 23) was treated with estradiol and progesterone. Group B was treated with granulocyte stimulation by intrauterine perfusion of IUD.Group C was treated with Foley balloon intrauterine infusion of G-CSF.Hyaluronic acid gel 3-5 ml was retained in uterine cavity after operation in all three groups.In the third month after operation, hysteroscopic second exploration was performed, and uterine cavity remodeling, endometrial thickness and menstrual recovery were recorded.Three months later, the patient was followed by telephone to prevent pregnancy.All data were statistically processed using SPSS 22. 0.Results: 1. General data of patients (age, number of abortion, weight, pregnancy, number of uterine cavity operations, onset time, preoperative endometrial thickness, degree of intrauterine adhesion,There was no significant difference between the three groups (P 0.05). There was no significant difference between the three groups in the effective rate of treatment, the effective rate of uterine cavity remodeling and the pregnancy rate of the three groups under hysteroscopy.Conclusion: after intrauterine adhesion separation under hysteroscopy, intrauterine IUD, IUD intrauterine perfusion, Foley balloon intrauterine perfusion, combined with sequential treatment of estrogen and progesterone and sodium hyaluronate can effectively prevent intrauterine adhesions.There was no significant difference in the effective rate of treatment, the effective rate of uterine cavity remodeling and pregnancy rate.
【學位授予單位】：廣西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R713.4

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本文編號：1772080