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目的:观察不同剂量戊酸雌二醇对宫腔粘连手术效果的影响和安全性。方法:选择宫腔粘连62例,行宫腔镜下宫腔粘连分离术,手术结束时放置宫内节育器,术后常规使用抗生素预防感染。术后第2天开始每天口服戊酸雌二醇,随机分为戊酸雌二醇3mg组和戊酸雌二醇9mg组各31例。戊酸雌二醇3mg组,3mg/次,每天1次;戊酸雌二醇9mg组,3mg/次,每天3次。均连续用药3个月。治疗结束后复查肝功能,宫腔镜下取出节育器,并再次镜检,评价术后效果。戊酸雌二醇9mg组分别于连续用药后2个月和3个月,采用超声监测子宫内膜厚度。结果:戊酸雌二醇9mg组治愈率77.4%,显著高于戊酸雌二醇3mg组的54.8%(P<0.05);宫腔再粘连发生率3.2%,显著低于戊酸雌二醇3mg组的32.2%(P<0.05)。戊酸雌二醇9mg组连续用药后2个月和3个月,超声监测子宫内膜厚度分别为3.8～7.5mm和7.2～11.6mm。结论:每天口服戊酸雌二醇9mg、连用3个月,用于宫腔粘连手术的效果优于每天口服戊酸雌二醇3mg,且较安全。
Objective: To observe the effect and safety of different doses of estradiol valerate on intrauterine adhesions. Methods: 62 cases of intrauterine adhesions were selected. Hysteroscopic intrauterine adhesions were performed. IUD was placed at the end of surgery. Antibiotics was used routinely to prevent infection. Estradiol valerate was orally administered on the second day after operation and was randomly divided into 31 mg of estradiol valerate 3 mg and estradiol valerate 9 mg respectively. Estradiol valerate 3mg group, 3mg / time, 1 day; valerate estradiol 9mg group, 3mg / time, 3 times a day. Continuous medication for 3 months. Liver function was checked after the treatment, and the IUD was removed under hysteroscopy, and the microscopic examination was again performed to evaluate the postoperative effect. Estradiol valerate 9 mg group were used to monitor endometrial thickness by ultrasound 2 months and 3 months after continuous administration respectively. Results: The cure rate of estradiol valerate 9mg was 77.4%, significantly higher than 54.8% of estradiol valerate 3mg (P <0.05); the rate of intrauterine reunion was 3.2%, which was significantly lower than estradiol valerate 32.2% of the 3 mg group (P <0.05). Estradiol valerate 9mg group 2 months and 3 months after continuous administration, ultrasound monitoring of endometrial thickness were 3.8 ~ 7.5mm and 7.2 ~ 11.6mm. CONCLUSION: Oral administration of 9 mg estradiol valerate per day for 3 months is more effective than oral administration of estradiol valerate 3 mg daily, and is safer.