摘要
目的:探讨宫内节育器(intrauterine device,IUD)辅助用于宫腔粘连电切术(transcervical resection of uterine adhesions,TCRA)对发生术后再粘连的影响。方法:回顾性分析2020年10月至2021年6月安庆市中医医院收治的82例中重度宫腔粘连(intrauterine adhesion,IUA)患者,根据TCR A术后处理方式不同分为两组,其中IUD组42例,球囊导尿管组40例。术后随访6~12个月,均在术后2个月再次行宫腔镜检查,比较两组美国生育协会(American Fertility Society,AFS)评分、宫腔形态恢复情况、宫腔再粘连发生率及妊娠率。结果:术后2个月,IUD组AFS评分显著低于球囊导尿管组(P<0.05),月经恢复率及宫腔形态恢复率显著高于球囊导尿管组(P<0.05),再粘连发生率与球囊导尿管组相比无显著差异(P>0.05)。术后随访6~12个月,两组临床妊娠率、生化妊娠率及异位妊娠率比较,差异无统计学意义(P>0.05)。结论:与球囊导尿管相比,TCRA术后置入IUD对患者AFS评分、月经及宫腔形态改善效果更明显,但在预防宫腔再粘连、提高妊娠率方面无显著优势。
Objective:To investigate the effect of intrauterine device(IUD)assisted transcervical resection of uterine adhesions(TCRA)on postoperative American Fertility Society(AFS)score,intrauterine morphology recovery and postoperative readhesion.Methods:From October 2020 to June 2021,A total of 82 patients with moderate to severe intrauterine adhesions(IUAs)admitted to Anqing Hospital of Traditional Chinese Medicine.According to the different treatment methods after TCRA,they were divided into two groups,42 cases in the IUD group and 40 cases in the balloon catheter group.Both group was followed up for 6–12 months,and hysteroscopy was performed after 2 months after the operation.The AFS score,recovery of uterine cavity morphology,intrauterine readhesion rate and pregnancy rate were compared between the two groups.Results:Two months after operation,the AFS score of IUD group was significantly lower than that of balloon catheter group(P<0.05);the effective rate of menstrual recovery and uterine cavity morphology recovery was significantly higher than that of balloon catheter group(P<0.05).There was no significant difference in the incidence of readhesion between IUD group and the balloon catheter group(P>0.05).Patients were followed up for 6-12 months,there was no significant difference in the clinical pregnancy rate,biochemical pregnancy rate and ectopic pregnancy rate between the two groups after one year of follow-up(P>0.05).Conclusion:Compared with balloon catheter,IUD implantation after TCRA has better effect on AFS,menstruation and uterine cavity morphology,but it has no obvious advantages in preventing intrauterine readhesion and improving pregnancy rate.
作者
章孔娟
王红梅
叶脉延
ZHANG Kongjuan;WANG Hongmei;YE Maiyan(Department of Gynecology,Anqing Hospital of Traditional Chinese Medicine,Anqing Anhui 246000,China)
出处
《临床与病理杂志》
CAS
2022年第7期1657-1662,共6页
Journal of Clinical and Pathological Research
关键词
宫腔粘连电切术
宫内节育器
宫腔形态
再粘连
transcervical resection of uterine adhesions
intrauterine device
uterine cavity morphology
readhesion
