本文選題：宮腔粘連 + 透明質(zhì)酸　； 參考：《重慶醫(yī)科大學(xué)學(xué)報》2017年04期

【摘要】：目的:探討交聯(lián)透明質(zhì)酸鈉凝膠在預(yù)防中重度宮腔粘連(intrauterine adhesion,IUA)術(shù)后再粘連中應(yīng)用的效果。方法:采用前瞻性隨機(jī)對照設(shè)計,選取2016年1月至2016年6月湖北省婦幼保健院收治的中重度宮腔粘連患者52例,隨機(jī)分為2組。所有患者均行宮腔鏡下宮腔粘連分離術(shù)(transcervical resection of adhesions,TCRA)。觀察組:26例,術(shù)畢宮腔放置Foley球囊+宮腔用交聯(lián)透明質(zhì)酸鈉凝膠,次日取出球囊,1周后復(fù)查宮腔鏡并再次注入交聯(lián)透明質(zhì)酸鈉凝膠;對照組:26例,術(shù)畢放置Foley球囊+普通醫(yī)用透明質(zhì)酸鈉,術(shù)后1周取出球囊,復(fù)查宮腔鏡并放置宮內(nèi)節(jié)育器。所有患者均行人工周期治療,每月行宮腔鏡復(fù)查。觀察術(shù)后3個月2組患者宮腔恢復(fù)、宮腔再粘連及月經(jīng)改善情況。結(jié)果:觀察組宮腔恢復(fù)率80.8%(21/26),對照組宮腔恢復(fù)率50.0%(13/26),差異有統(tǒng)計學(xué)意義(P=0.02)。觀察組宮腔再粘連率3.8%(1/26),對照組26.9%(7/26);觀察組月經(jīng)改善率84.6%(22/26),對照組61.5%(16/26),但2組比較,差異無統(tǒng)計學(xué)意義(P0.05)。2組治療效果比較,經(jīng)U檢驗差異有統(tǒng)計學(xué)意義(P=0.01)。結(jié)論:TCRA術(shù)后宮腔使用交聯(lián)透明質(zhì)酸鈉凝膠作為生物屏障,輔助雌激素修復(fù)子宮內(nèi)膜可有效改善宮腔恢復(fù)率及IUA治療效果,是預(yù)防宮腔再粘連的有效方法。
[Abstract]:Objective: to investigate the effect of cross-linked sodium hyaluronate gel in preventing intrauterine adhesion after intrauterine adhesion (IUAA). Methods: a prospective randomized controlled design was used to select 52 patients with moderate or severe intrauterine adhesion from January 2016 to June 2016 in Hubei Maternal and Child Health Care Hospital, and were randomly divided into 2 groups. All patients were treated with transcervical resection of adhesions under hysteroscopy. In the observation group, 26 cases were treated with Foley balloon intrauterine cavity after operation, and then treated with sodium hyaluronate gel. The next day, the hysteroscopy was taken out one week later and the cross-linked sodium hyaluronate gel was injected again in the control group (n = 26), while the control group (n = 26) was treated with sodium hyaluronate gel. Foley balloon sodium hyaluronate was placed at the end of the operation. The balloon was removed 1 week after operation, and the hysteroscopy was re-examined and intrauterine device was placed. All patients were treated with manual cycle therapy, and hysteroscopy was performed monthly. The recovery of uterine cavity, re-adhesion of uterine cavity and menorrhagia were observed 3 months after operation. Results: the recovery rate of uterine cavity in the observation group was 80.8%, and the recovery rate in the control group was 50.0%. The difference was statistically significant. In the observation group, the rate of uterine cavity readhesion was 3.8g / 26g, the control group was 26.9g / 26g, the menorrhagia improvement rate of the observation group was 84.6n22 / 26g, and the control group 61.5g / 26, but the difference between the two groups was not statistically significant (P 0.05), but there was a significant difference between the two groups (P 0.05N), but there was a significant difference between the two groups (P 0.01). Conclusion the use of cross-linked sodium hyaluronate gel as a biological barrier in uterine cavity after TCR A can effectively improve the recovery rate of uterine cavity and the therapeutic effect of IUA. It is an effective method to prevent uterine cavity re-adhesion.
【作者單位】： 湖北省婦幼保健院婦科;首都醫(yī)科大學(xué)附屬北京婦產(chǎn)醫(yī)院;
【基金】：湖北省科技廳自然科學(xué)基金資助項目(編號:2011CDC070)
【分類號】：R713.4

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