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目的:观察宫腔粘连(IUA)分解术后宫腔内放入玻璃酸钠联合大剂量雌激素口服预防再粘连的效果。方法:宫腔镜确诊为IUA患者272例,分为A组和B组,A组(n=103)行宫腔镜下IUA分离术及宫腔内节育器(IUD)放置术,术后口服大剂量雌激素及孕激素人工周期3个月;B组(n=169)在A组相同治疗的基础上加宫腔内留置玻璃酸钠;比较A组和B组的疗效。结果:中度粘连患者术后粘连再发率B组显著低于A组(P<0.05);A、B组的治疗有效率分别为:轻度粘连100%、100%;中度粘连83.3%、94.6%;重度粘连68.2%、83.9%(P均>0.05);轻、中度IUA的治愈率B组显著高于A组(P<0.05)。结论:IUA分解术后宫腔内留置玻璃酸钠联合大剂量雌激素口服可提高预防再粘连的效果,特别对轻、中度IUA效果显著。
Objective: To observe the effect of intrauterine administration of sodium hyaluronate combined with high-dose estrogen orally to prevent re-adhesion after intrauterine myometrial adhesion (IUA) disintegration. Methods: A total of 272 patients with IUA diagnosed by hysteroscopy were divided into group A and group B. Group A (n = 103) underwent hysteroscopic IUA and intrauterine device insertion (IUD) The dosage of estrogen and progestin in artificial period was 3 months. In group B (n = 169), sodium hyaluronate was kept in uterine cavity on the basis of the same treatment in group A; the curative effect of group A and group B was compared. Results: The rate of postoperative adhesion recurrence in group B was significantly lower than that in group A (P <0.05). The effective rates of group A and group B were 100% mild adhesion, 100% moderate adhesion, 83.3% , 94.6%, severe adhesion 68.2%, 83.9% (all P> 0.05). The cure rate of mild and moderate IUA in group B was significantly higher than that in group A (P <0.05). Conclusion: IUA intrauterine uterine distention after intrauterine sodium hyaluronate oral administration of large doses of estrogen can improve the prevention of re-adhesion effect, especially for mild to moderate IUA effect.