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目的比较宫腔镜下宫腔粘连(intrauterine adhesion,IUA)电切术后不同预防粘连方法的效果。方法 190例宫腔镜下IUA电切术后患者,随机分为4组,第1组48例,术后口服戊酸雌二醇(补佳乐);第2组46例,术后放置宫内节育器(intrauterine contraceptivedevice,IUD)+补佳乐;第3组45例,术后放置Foley球囊导尿管+补佳乐;第4组51例,术后宫腔注入几丁糖+补佳乐。术后3个月宫腔镜下观察4组宫腔情况。结果 4组宫腔再粘连率分别为37.50%、15.22%、13.33%、9.8%,2、3、4组防治IUA有效率(包括治愈与好转)明显高于1组(P<0.05),2、3、4组之间防治IUA有效率比较差异无统计学意义(P>0.05)。结论 IUA电切术后在应用补佳乐基础上放置IUD或球囊导尿管或应用几丁糖,能显著减少术后宫腔再粘连的发生,其中放置IUD+口服戊酸雌二醇方法经济、实用。
Objective To compare the effects of different methods of preventing adhesions after hysteroscopic resection of intrauterine adhesion (IUA). Methods 190 cases of hysteroscopic IUA resection patients were randomly divided into 4 groups, 48 cases in group 1, after oral administration of estradiol valerate (nivalyl); group 2 46 cases, Intrauterine contraceptive device (IUD) + nadrogol; group 3 45 cases, postoperative placement of Foley balloon catheters plus naloxone; group 4 51 cases, intrauterine injection of chitosan + Good music. Three months after hysteroscopic observation of the uterine cavity in four groups. Results The intrauterine reattached rates in the four groups were 37.50%, 15.22%, 13.33% and 9.8%, respectively. The IUA effective rates (including cure and improvement) in groups 2 and 3 were significantly higher than those in group 1 (P <0.05) There was no significant difference in the effective rate of prevention and treatment of IUA between the three groups (P> 0.05). Conclusions After IUA resection, placement of IUD or balloon catheter or chitosan on the basis of nadropine can significantly reduce the occurrence of intrauterine reocclusion. The method of placing IUD + oral administration of estradiol valerate is economical ,practical.