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目的:评价人羊膜在宫腔粘连松解术(TCRA)后置入宫腔的安全性及预付再粘连的有效性。方法:回顾性分析34例宫腔中、重度粘连的不孕患者宫腔粘连松解术后宫腔内放置表面被覆羊膜的Foley’s球囊,1周后取出,同时给予雌激素/黄体酮周期治疗。术后第1、3个月宫腔镜检查。随访观察粘连复发率,月经改善和妊娠结局。结果:12例中度粘连组(A组)和22例重度粘连组(B组)患者手术均顺利且无并发症发生,围手术期均无感染症状。A组中75%的患者和B组中45.5%的患者月经恢复正常或得到明显改善。A组无一例宫腔粘连复发,B组中11例复发。所有患者宫内妊娠率为35.3%(12/34)。结论:人羊膜+雌激素/黄体酮周期治疗安全、有效,并能预防宫腔再次粘连的有效方法。
Objective: To evaluate the safety of human amniotic membrane placement in the uterine cavity after intrauterine adhesions lysis (TCRA) and the effectiveness of advanced adhesion. Methods: A retrospective analysis of 34 cases of intrauterine and severe adhesion of infertility patients after intrauterine adhesions lysis intrauterine surface amniotic membrane Foley’s placed the amniotic membrane, removed after 1 week, given estrogen / progesterone cycle treatment . Hysteroscopy in the first and third month after operation. Follow-up observation of adhesion recurrence rate, menstrual improvement and pregnancy outcome. Results: The operation of 12 cases of moderate adhesion group (group A) and 22 cases of severe adhesion group (group B) were successful and no complications occurred. There was no infection during perioperative period. 75% of patients in group A and 45.5% of patients in group B had normal menstruation or were significantly improved. None of the patients in group A had recurrent uterine adhesions, and 11 patients in group B relapsed. The intrauterine pregnancy rate was 35.3% (12/34) in all patients. Conclusion: Human amniotic membrane + estrogen / progesterone cycle treatment is safe and effective, and can prevent intrauterine adhesions again effective method.