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目的:研究重度宫腔粘连宫腔镜下粘连分离术后宫腔持续放置球囊导尿管的作用。方法:将重度宫腔粘连患者106例随机分为实验组及对照组,两组患者均给予宫腔镜下宫腔粘连分离术,术后对照组上环,倍美力及黄体酮胶丸行人工周期,抗生素预防感染;实验组则术后宫腔放置球囊导尿管,充水3ml～5ml,隔日补充1ml～2ml,充水量也以病人勉强能耐受为宜,球囊充水总量6ml～8ml,导尿管持续开放1周后拔除。并予宫腔隔日推注己烯雌酚及透明质酸钠,其余上环、人工周期处理与对照组相同。结果:实验组术后3个月复查宫腔镜,宫腔形态正常率及月经量恢复正常率明显高于对照组(P<0.05,P<0.05),且其治愈率及远期受孕率也较对照组升高(P<0.05,P<0.05)。结论:对于重度宫腔粘连的治疗,粘连分离术后加用冲水球囊导尿管一周后上环较单纯使用节育环治疗效果显著,值得临床推广。
Objective: To study the effect of continuous placement of balloon catheters in uterine cavity after hysteroscopic adhesions in severe intrauterine adhesions. Methods: One hundred and sixty patients with severe intrauterine adhesions were randomly divided into experimental group and control group. Hysteroscopic intrauterine adhesions were performed in both groups. Patients in control group were treated with Shehuan, Beimei and progesterone Artificial cycle, antibiotics to prevent infection; experimental group was placed after the uterine balloon catheter, filled with water 3ml ~ 5ml, every other day to add 1ml ~ 2ml, water volume is also barely able to tolerate the patient is appropriate, the total filling of the balloon Volume 6ml ~ 8ml, the catheter continued to open one week after the removal. And intrauterine injection of diethylstilbestrol and sodium hyaluronate every other day, the rest of the ring, the same artificial cycle and control group. Results: The hysteroscopy, the normal rate of uterine cavity morphology and the recovery rate of menstrual flow in the experimental group were significantly higher than those in the control group (P <0.05, P <0.05), and the cure rate and long-term conception rate Compared with the control group (P <0.05, P <0.05). CONCLUSIONS: For the treatment of severe intrauterine adhesions, the use of flushing balloon catheters after adhesion separation is superior to the simple use of contraceptive rings in one week, which is worthy of clinical promotion.