论文部分内容阅读
目的研究分析宫腔粘连患者于宫腔镜下行宫腔粘连分离术并使用不同剂量戊酸雌二醇预防再粘连的疗效。方法以长沙市中心医院妇产科2009年10月至2014年10月10年治疗的宫颈粘连患者为研究对象,随机分为三组进行对照比较研究。其中38例患者行宫腔镜下宫腔粘连分离术并安置节育环,术后运用6 mg/d戊酸雌二醇(小剂量组);49例患者行相同手术并安置节育环,术后运用10 mg/d戊酸雌二醇(大剂量组);另外29例患者行相同手术,术后留置Foley导尿管并取出后再安置节育环(安置Foley导尿管组)。治疗后观察子宫内膜厚度及月经量,根据疗效评价标准比较疗效。结果三组患者宫腔镜下宫腔粘连分离术后与加服用黄体酮前子宫内膜厚度比较差异有统计学意义(P<0.05);三组患者加服用黄体酮前子宫内膜厚度比较差异有统计学意义(P<0.05)。三组患者术前与治疗后平均月经量比较差异有统计学意义(P<0.05);三组治疗后平均月经量比较差异有统计学意义(P<0.05)。大剂量组治疗疗效优于小剂量组及安置Foley导尿管组(P<0.05或P<0.01)。结论 E2V能促进子宫内膜增生,且大剂量E2V促进子宫内膜增生更显著,对预防宫腔粘连具有可靠的疗效。但E2V使用剂量、时间与最大的疗效获益需要进一步大样本研究。
Objective To study the effect of intrauterine adhesions in hysteroscopic intrauterine adhesions and the use of different doses of estradiol valerate to prevent adhesion. Methods Cervical adhesions patients treated in Changsha Central Hospital Obstetrics and Gynecology from October 2009 to October 2014 for 10 years were randomly divided into three groups and compared with each other. Among them, 38 patients underwent hysteroscopic intrauterine adhesions separation and placement of contraceptive rings, postoperative use of 6 mg / d estradiol valerate (low-dose group); 49 patients underwent the same surgery and placement of contraceptive rings, postoperative use 10 mg / d estradiol valerate (high-dose group). The other 29 patients underwent the same surgery. After the procedure, the Foley catheter was placed and removed and the contraceptive ring was placed (Foley catheterization). Endometrial thickness and menstrual flow were observed after treatment, and the curative effect was compared according to the evaluation criteria of curative effect. Results There were significant differences in the thickness of uterine endometrium between the three groups before and after uterine cavity adhesions (P <0.05). The thickness of uterine endometrium in three groups before and after taking progesterone was significantly different There was statistical significance (P <0.05). The average menstrual volume of the three groups before and after treatment was significantly different (P <0.05). The average menstrual volume of the three groups after treatment was significantly different (P <0.05). The efficacy of high-dose group was better than that of low-dose group and placement of Foley catheter group (P <0.05 or P <0.01). Conclusion E2V can promote endometrial hyperplasia, and high-dose E2V promote endometrial hyperplasia more significant, to prevent intrauterine adhesions with a reliable effect. However, E2V use of dose, time and maximum benefit from the need for further large sample studies.