【摘要】：目的:探究宮腔粘連分離術后宮腔內置入包裹生物防粘連膜的宮內節(jié)育器(intrauterine device,IUD)與防粘連膜預防粘連復發(fā)的療效。方法:回顧性分析2015年7月至2016年7月重慶醫(yī)科大學附屬第一醫(yī)院經(jīng)宮腔鏡檢查診斷為中重度IUA患者120例,于宮腔鏡粘連分離術后被隨機分為A組(包裹生物防粘連膜的金屬圓形IUD被置入宮腔)70例,B組(生物防粘連膜被置入宮腔)50例。對照2組患者術后的再粘連形成、月經(jīng)量的變化、宮腔解剖構造恢復、妊娠情況。結果:術后A組宮腔再粘連發(fā)生率(37.1%)明顯低于B組再粘連發(fā)生率(56.0%),P=0.041;A、B組妊娠率分別為22.9%、22.0%(P=0.912);A、B組月經(jīng)量治療有效率(治愈率+改善率)分別為72.9%、62.0%(P=0.523);A、B組宮腔形態(tài)恢復有效率(治愈率+改善率)分別為100%、98%(P=0.554)。結論:術后宮腔內留置金屬圓形IUD+生物防粘連膜防止粘連復發(fā)的效果明顯優(yōu)于單純放置防粘連膜,而對于改善月經(jīng)、恢復宮腔解剖結構及妊娠,2種方法均可。
[Abstract]:Objective: to investigate the effect of intrauterine device and antiadhesion membrane after intrauterine adhesion separation. Methods: from July 2015 to July 2016, 120 patients with moderate and severe IUA diagnosed by hysteroscopy in the first affiliated Hospital of Chongqing Medical University were analyzed retrospectively. After hysteroscopic adhesion separation, 50 cases were randomly divided into group A (70 cases with biofilm enclosing metallic circular IUD implanted into uterine cavity) and group B (50 cases with biofilm implanted into uterine cavity). The readhesions, menstrual volume, anatomic structure of uterine cavity and pregnancy were observed in the control group. Results: the incidence of intrauterine re-adhesion in group A (37.1%) was significantly lower than that in group B (56.0%). The pregnancy rate of group A was 22.90.22% (P 0.912) the effective rate of menstrual volume therapy (cure rate) was 72.9% (P 0.523) and the rate of recovery of uterine cavity in group A was 72.9% (P 0.523). The cure rate was 100 / 98% (P < 0. 554). Conclusion: the effect of intrauterine indwelling metal circular IUD biofilm to prevent the recurrence of adhesion is better than that of simple placement of anti-adhesion membrane, but it can be used to improve menstruation, restore the anatomic structure of uterine cavity and pregnancy.
【作者單位】： 重慶醫(yī)科大學附屬第一醫(yī)院婦產(chǎn)科;
【基金】：國家自然科學基金資助項目(編號:81471417)
【分類號】：R713.4

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