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目的观察大剂量雌激素对中重度宫腔粘连(IUA)宫腔镜宫腔粘连分离术(TCRA)后患者预防宫腔再粘连的疗效。方法选取行TCRA的中重度IUA患者50例作为研究对象。根据术后服用雌激素剂量不同分为试验组和对照组各25例。试验组患者服用大剂量雌激素;对照组患者服用正常剂量雌激素。比较2组患者治疗后月经改善、宫腔再粘连、妊娠情况和药物不良反应。结果试验组患者月经改善有效率为80.0%明显高于对照组的52.0%,差异有统计学意义(P<0.05)。术后第4个月对患者进行随访,行宫腔镜探查。试验组术后宫腔再粘连发生率为24.0%(6/25)低于对照组的48.0%(12/25),差异有统计学意义(P<0.05)。2组间妊娠率、分娩率比较差异均无统计学意义(P>0.05)。2组药物不良反应发生率比较差异无统计学意义(P>0.05)。结论大剂量雌激素能够有效预防中重度IUA患者TCRA术后宫腔再粘连,并且无明显不良反应。
Objective To observe the effect of high-dose estrogen on the prevention of intrauterine re-adhesion in patients with moderate-severe uterine adhesions (IUA) after hysteroscopic hysteroscopic adhesions (TCRA). Methods Fifty patients with moderate-severe IUA who underwent TCRA were selected as the study subjects. According to the dose of estrogen after surgery divided into experimental group and control group of 25 cases. Patients in the test group took large doses of estrogen; patients in the control group took normal doses of estrogen. After treatment, the improvement of menstruation, intrauterine adhesions, pregnancy and adverse drug reactions were compared between the two groups. Results The effective rate of menstrual improvement in trial group was 80.0%, which was significantly higher than that in control group (52.0%), the difference was statistically significant (P <0.05). After 4 months of follow-up of patients, hysteroscopy. The incidence of intrauterine reocclusion in the experimental group was 24.0% (6/25), which was lower than that in the control group (48.0%, 12/25) (P <0.05). There was no significant difference in pregnancy rate and delivery between the two groups (P> 0.05). There was no significant difference in the incidence of adverse drug reactions between the two groups (P> 0.05). Conclusions High-dose estrogen can effectively prevent uterine adhesions after TCRA in moderate-severe IUA patients without obvious adverse reactions.