CAJ | 학술논문

目的：探讨宫腔粘连术后预防再发粘连的药物应用方法与效果。方法重度宫腔粘连患者240例，根据随机抽签法分为治疗组120例与对照组120例，所有患者都给予宫腔粘连分离术，治疗组术后口服雌激素，对照组术后未服用雌激素，术后随访1年。结果经过随访调查，宫腔粘连术后，对照组宫腔再粘连率约为27．5%，治疗组为5．0%，治疗组预防再发粘连的效果显著优于对照组(P<0．05)。宫腔粘连术后，治疗组月经改善率为90．8%，对照组为61．7%，治疗组术后月经改善率明显高于对照组( P<0．05)。两组术后乳房胀痛、胃肠道反应、阴道不规则出血、肝肾功能损害等不良反应情况比较差异无统计学意义( P>0．05)。治疗组的妊娠率与分娩率分别为55．8%和25．8%，而对照组分别为27．5%和11．7%，治疗组的妊娠率与分娩率明显高于对照组(P<0．05)。结论宫腔粘连术后口服雌激素能有效预防术后粘连的发生，安全性好，能改善月经状况，从而提高术后妊娠率与分娩率。
목적：탐토궁강점련술후예방재발점련적약물응용방법여효과。방법중도궁강점련환자240례，근거수궤추첨법분위치료조120례여대조조120례，소유환자도급여궁강점련분리술，치료조술후구복자격소，대조조술후미복용자격소，술후수방1년。결과경과수방조사，궁강점련술후，대조조궁강재점련솔약위27．5%，치료조위5．0%，치료조예방재발점련적효과현저우우대조조(P<0．05)。궁강점련술후，치료조월경개선솔위90．8%，대조조위61．7%，치료조술후월경개선솔명현고우대조조( P<0．05)。량조술후유방창통、위장도반응、음도불규칙출혈、간신공능손해등불량반응정황비교차이무통계학의의( P>0．05)。치료조적임신솔여분면솔분별위55．8%화25．8%，이대조조분별위27．5%화11．7%，치료조적임신솔여분면솔명현고우대조조(P<0．05)。결론궁강점련술후구복자격소능유효예방술후점련적발생，안전성호，능개선월경상황，종이제고술후임신솔여분면솔。
Objective To investigate the effects of estrogen on recurrent postoperative intrauterine adhe-sions. Methods 240 patients with severe intrauterine adhesions were equally randomly divided into treatment group (n=120) and control group (n =120),all the patients were given intrauterine adhesions dissection,and treatment group received oral estrogen after operation. All the patients were followed up for 1 year. Results In the followed-up survey, the postoperative adhesions recurrence in treatment group was lower than that of control group ( 5. 0%vs. 27. 5%,P <0. 05 ) . The menstrual improvement rate in treatment group was higher than that of control group (90. 8% vs. 61. 7%,P<0. 05). There was no significant difference in postoperative breast pain,gastrointestinal reac-tions,abnormal vaginal bleeding,liver and kidney dysfunction and other adverse reactions between the two groups ( P>0. 05) . The pregnancy and delivery rates of treatment group were higher than those of control group ( 55. 8%vs. 27. 5%,25. 8% vs. 11. 7%, P <0. 05 ) . Conclusion Estrogen could prevent the postoperative intrauterine adhe-sions with good safety,it can improve menstrual status,thereby increase the rates of postoperative pregnancy and child-birth.