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目的探讨放置防粘连膜或注水球囊预防重度宫腔粘连术后复发的疗效。方法回顾性分析2009年6月至2014年6月南方医科大学附属深圳妇幼保健院收治的80例重度宫腔粘连患者,所有病人均行宫腔镜下宫腔粘连分离术(TCRA),术后服用戊酸雌二醇3个月。根据术后处理方法分成3组。A组(34例):术后放置宫内节育器(IUD);B组(23例):术后放置Foley球囊导尿管,同时注入透明质酸钠凝胶,3 d后再次注入透明质酸钠凝胶并取出球囊,宫内放置IUD。在术后第1、2个月月经干净后3~5 d内,再次取环并放置球囊导尿管,3 d后取出重新放置IUD;C组(23例):术后放置氧化再生防粘连膜(interceed)+IUD。术后3个月,均行二次宫腔镜探查,评估治疗效果。结果 B组治疗总有效率87%(20/23),C组治疗总有效率96%(22/23),均明显高于A组(62%,21/34),差异有统计学意义(P<0.05);C组的总有效率高于B组,但两组比较差异无统计学意义(P>0.05)。结论 TCRA术后放置球囊导尿管或防粘连膜均可有效预防重度宫腔粘连术后复发。
Objective To investigate the curative effect of preventing the recurrence of severe intrauterine adhesions by placing anti-adhesion membrane or water-filled balloon. Methods A retrospective analysis of 80 patients with severe intrauterine adhesions treated in Shenzhen Maternal and Child Health Hospital affiliated to Southern Medical University from June 2009 to June 2014 was performed. All patients underwent hysteroscopic intrauterine adhesions (TCRA) Estradiol valerate 3 months. According to postoperative treatment method is divided into 3 groups. In group A (34 cases), intrauterine device (IUD) was placed after operation. In group B (23 cases), Foley balloon catheter was placed after operation and sodium hyaluronate gel was injected simultaneously. Sodium saccharide gel and remove the balloon, intrauterine placement IUD. In the first and second month after the menstrual clean 3 ~ 5 d, again take the ring and placed the balloon catheter, 3 d removed and re-placed IUD; C group (23 cases): postoperative placed oxidative regeneration Interceed + IUD. Three months after operation, all patients underwent second hysteroscopy to evaluate the therapeutic effect. Results The total effective rate was 87% (20/23) in group B and 96% (22/23) in group C, which was significantly higher than that in group A (62%, 21/34) P <0.05). The total effective rate in group C was higher than that in group B, but there was no significant difference between the two groups (P> 0.05). Conclusions The placement of balloon catheters or anti-adhesion membranes after TCRA can effectively prevent the recurrence of severe intrauterine adhesions.