两种不同方法分离宫腔粘连的临床观察.docVIP

两种不同方法分离宫腔粘连的临床观察 　　[摘要] 目的 探讨两种不同方法分离宫腔粘连的预后。 方法 将中重度宫腔粘连患者随机分为研究组（32例）和对照组（30例），研究组采用宫腔镜下微型剪刀切除术，对照组采用宫腔镜下电切术。两组术后均予上环术加透明质酸钠宫腔内注射及雌、孕激素人工周期治疗3个月；术后1、3个月行宫腔镜检查；术后6、18个月各进行随访1次。结果 研究组与对照组术后3个月宫腔形态恢复总有效率分别为90.6%（29/32）、93.3%（28/30）；月经改善总有效率分别为81.3%（26/32）、80.0%（24/30）；宫腔粘连的复发率分别为15.6%（5/32）、13.3%（4/30）；妊娠率分别为34.6%（9/26）、27.3%（6/22)；两组比较差异无统计学意义（P0.05）。两组住院天数、手术费用、总费用比较差异有统计学意义（P0.001）。两组均无明显的药物不良反应及手术并发症。 结论 两种不同方法分离宫腔粘连疗效无统计学差异，宫腔镜下微型剪刀切除术是一种值得临床推广的治疗方法。 　　[关键词] 宫腔粘连；宫腔镜；电切术；微型剪刀切除术；预后 　　[中图分类号] R713[文献标识码] A[文章编号] 1674-4721（2014）06（a）-0070-04 　　 　　Clinical observation of two different methods of separation of intrauterine adhesions 　　LONG Wen-xiang YANG Zhang-li LI Rong-ying ZHOU Chun-hui▲ 　　Maternal and Child Care Service Centre of Zhuzhou City in Hunan Province,Zhuzhou 412008,China 　　[Abstract] Objective To explore the prognosis of two different methods of separation of intrauterine adhesions. Methods Moderately severe intrauterine adhesions patients were randomly divided into two groups,the study group (32 cases) were given with micro scissors resection under hysteroscopy,the control group (30 cases) were given with hysteroscopic electric resection.Two groups of patients were treated with surgery combined with sodium hyaluronate on intrauterine injection of estrogen,progesterone and artificial cycle therapy for 3 months;after 1,3 months for hysteroscopy;after 6,18 months respectively were followed up 1 time. Results The uterine morphology recovery rate of study group and control group was 90.6% (29/32),93.3% (28/30) respectively;menstrual improvement rates were 81.3% (26/32),80.0% (24/30);recurrence of intrauterine adhesions were 15.6% (5/32),13.3% (4/30);pregnancy rate was 34.6% (9/26),27.3% (6/22) respectively; the two groups had no statistical difference (P0.05).Two groups of hospitalization days,operation cost,total cost had significant difference (P0.05).The two groups had no obvious adverse reaction and complication of operation. Conclusion Tw