妇产与遗传（电子版）
婦產與遺傳（電子版）
부산여유전（전자판）
Obstetrics-Gynecology and Genetics(Electronic Edition)
2014年
2期
14-17
,共4页
朱伟艳%成志%吴海燕%刘永珠%陈北秀%欧阳一兵
硃偉豔%成誌%吳海燕%劉永珠%陳北秀%歐暘一兵
주위염%성지%오해연%류영주%진북수%구양일병
宫腔粘连%节育器%气囊双腔导尿管%几丁糖%疗效
宮腔粘連%節育器%氣囊雙腔導尿管%幾丁糖%療效
궁강점련%절육기%기낭쌍강도뇨관%궤정당%료효
intrauterine adhesions%intrauterine device%double balloon catheter%chitosan%curative effects
目的：研究宫腔镜宫腔粘连电切术后放置宫内节育器、气囊双腔导尿管或几丁糖联合预防宫腔再粘连的疗效。方法回顾分析我院134例III型、IV型宫腔粘连行宫腔镜电切分离患者，术后采用3种不同方法防止宫腔粘连再发，其中A组40例，于宫腔镜电切分离术后放置宫内节育器联合补佳乐（戊酸雌二醇）和地屈孕酮治疗；B组56例，于宫腔镜电切分离术后放置气囊双腔导尿管联合补佳乐和地屈孕酮治疗；C组38例，于宫腔镜电切分离术后放置几丁糖联合补佳乐和地屈孕酮治疗。结果三组宫腔形态恢复情况，A组宫腔形态恢复有效率为80.0%，B组宫腔形态恢复有效率为94.6%，C组宫腔形态恢复有效率为81.6%，B组宫腔形态恢复有效率显著高于A、C组（P<0.05），有统计学意义；三组月经量恢复结果，A组月经恢复有效率为72.5%，B组月经恢复有效率为92.8%，C组月经恢复有效率为78.9%，B组月经量恢复率高于A组和C组，差异有统计学意义（P<0.05）。结论宫腔粘连术后放置气囊双腔导尿管联合补佳乐和地屈孕酮能更有效预防再粘连的发生。
目的：研究宮腔鏡宮腔粘連電切術後放置宮內節育器、氣囊雙腔導尿管或幾丁糖聯閤預防宮腔再粘連的療效。方法迴顧分析我院134例III型、IV型宮腔粘連行宮腔鏡電切分離患者，術後採用3種不同方法防止宮腔粘連再髮，其中A組40例，于宮腔鏡電切分離術後放置宮內節育器聯閤補佳樂（戊痠雌二醇）和地屈孕酮治療；B組56例，于宮腔鏡電切分離術後放置氣囊雙腔導尿管聯閤補佳樂和地屈孕酮治療；C組38例，于宮腔鏡電切分離術後放置幾丁糖聯閤補佳樂和地屈孕酮治療。結果三組宮腔形態恢複情況，A組宮腔形態恢複有效率為80.0%，B組宮腔形態恢複有效率為94.6%，C組宮腔形態恢複有效率為81.6%，B組宮腔形態恢複有效率顯著高于A、C組（P<0.05），有統計學意義；三組月經量恢複結果，A組月經恢複有效率為72.5%，B組月經恢複有效率為92.8%，C組月經恢複有效率為78.9%，B組月經量恢複率高于A組和C組，差異有統計學意義（P<0.05）。結論宮腔粘連術後放置氣囊雙腔導尿管聯閤補佳樂和地屈孕酮能更有效預防再粘連的髮生。
목적：연구궁강경궁강점련전절술후방치궁내절육기、기낭쌍강도뇨관혹궤정당연합예방궁강재점련적료효。방법회고분석아원134례III형、IV형궁강점련행궁강경전절분리환자，술후채용3충불동방법방지궁강점련재발，기중A조40례，우궁강경전절분리술후방치궁내절육기연합보가악（무산자이순）화지굴잉동치료；B조56례，우궁강경전절분리술후방치기낭쌍강도뇨관연합보가악화지굴잉동치료；C조38례，우궁강경전절분리술후방치궤정당연합보가악화지굴잉동치료。결과삼조궁강형태회복정황，A조궁강형태회복유효솔위80.0%，B조궁강형태회복유효솔위94.6%，C조궁강형태회복유효솔위81.6%，B조궁강형태회복유효솔현저고우A、C조（P<0.05），유통계학의의；삼조월경량회복결과，A조월경회복유효솔위72.5%，B조월경회복유효솔위92.8%，C조월경회복유효솔위78.9%，B조월경량회복솔고우A조화C조，차이유통계학의의（P<0.05）。결론궁강점련술후방치기낭쌍강도뇨관연합보가악화지굴잉동능경유효예방재점련적발생。
Objective To study the efficacy of treating intrauterine adhesions by placing intrauterine device, placing double balloon catheter or using chitosan after hysteroscopic electrocision in preventing recurrence. Methods 134 cases of III and IV type intrauterine adhesions patients underwent hysteroscopic electrocision and adopted three different ways to prevent recurrence were retrospectively analyzed. All the cases were divided into 3 groups: Group A(n=40): intrauterine device was placed after surgery, and patients were treated with progynova (estradiol valerate) and dydrogesterone; Group B(n=56), double balloon catheter was placed after surgery and patients were treated with progynova and dydrogesterone;Group C(n=38), chitosan was placed after surgery and the patients were treated with progynova and dydrogesterone. Results Recovering conditions of intrauterine appearance in three groups are as following:effective rate of intrauterine appearance recovering in Group A is 80.0%, Group B is 94.6%, Group C is 81.6%, which shows a statistical significance(P=0.045 and P<0.05); recovering results of menstrual cycle in three groups are as following: the effective rate of menstrual cycle recovering in Group A is 72.5%, Group B is 92.8%, Group C is 86.8%, and Group B is higher than Group A and Group C which exists a statistical significance (P<0.05). Conclusions Placing double balloon catheter combined with treatment of progynova and progesterone after hysteroscopic electrocision has a better effectiveness in in preventing the recurrence of intrauterine adhesions.
