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目的:探讨羊膜移植对预防宫腔粘连电切术后宫腔再粘连的效果。方法:2011年4月～2012年8月在新乡医学院第三附属医院妇产科行宫腔镜诊断的宫腔粘连患者70例,在B超监护下探测宫腔深度及方向,再用宫颈扩张棒逐号扩张至11.5号,所有患者在B超监护下,按科学合理的宫腔镜常规操作,采用环状或针状电极电切的方法。术中记录手术所用时间及灌流量。术后宫腔内放14Fr～10 ml双腔气囊导尿管,去除球囊顶端部,囊内充水3～9 ml。球囊外敷新鲜羊膜同时接引流袋持续开放引流。术后预防感染治疗5天,术后第二天采用雌、孕激素序贯疗法建立人工月经周期3个月,必要时进行第二次分离术。结果:70例宫腔粘连中包括轻度37例,中度22例,重度11例,术后观察1～6个月,宫腔形态恢复正常67例,有效率达到了95.7%,只有3例无效(均为重度患者)。结论:进行宫腔镜宫腔粘连分离术时配合羊膜移植对治疗宫腔粘连及预防宫腔再粘连效果好,操作简单,值得推广。
Objective: To investigate the effect of amniotic membrane transplantation on the prevention of intrauterine adhesions after intrauterine adhesion resection. Methods: From April 2011 to August 2012, 70 cases of intrauterine adhesions diagnosed by hysteroscopy in obstetrics and gynecology department of the Third Affiliated Hospital of Xinxiang Medical College were enrolled in this study. The depth and direction of uterine cavity were detected under B-ultrasound, Stick number by number expansion to 11.5, all patients under B-ultrasound, according to the scientific and reasonable hysteroscopic routine operation, the use of circular or needle-like electrode cutting method. Intraoperative recording of surgery time and perfusion. Postoperative uterine cavity placed 14Fr ~ 10 ml double-lumen balloon catheter to remove the top of the balloon, the capsule filled with water 3 ~ 9 ml. Balloon applied fresh amniotic membrane at the same time connected to the drainage bag continued to open drainage. Postoperative infection prevention treatment for 5 days, the day after surgery using estrogen and progesterone sequential therapy to establish artificial menstrual cycle for 3 months, if necessary, the second separation. Results: 70 cases of intrauterine adhesions included mild 37 cases, moderate 22 cases, severe 11 cases, postoperative observation 1 to 6 months, uterine cavity morphology returned to normal 67 cases, the effective rate reached 95.7%, only 3 cases Invalid (both severe patients). Conclusion: Hysteroscopic intrauterine adhesions in combination with amniotic membrane transplantation for the treatment of intrauterine adhesions and prevention of intrauterine re adhesion effect is good, simple operation, it is worth promoting.