宫腔镜诊治中、重度宫腔粘连48例临床分析

目的通过对中、重度宫腔粘连患者电切术后综合分析,探讨宫腔粘连电切术后防止再次粘连的方法。方法回顾性分析48例因宫腔粘连行宫腔镜宫腔粘连电切术患者的临床资料。结果宫腔粘连以月经异常为主要表现,占87.5%(42/48)。宫腔操作次数越多,发生重度粘连的机会越大(P<0.05)。术后门诊随访48例患者月经恢复情况,术后3个月复查宫腔镜了解患者宫腔恢复情况,治疗总有效率为79.1%(38/48)。术前宫腔粘连程度越重,治疗效果越差(P<0.05)。结论宫腔镜下宫腔粘连电切术是治疗宫腔粘连的有效方法,术后通过放置宫内节育器、宫腔球囊以及给予人工周期能有效防止再次宫腔粘连,如何防止重度宫腔粘连者再次粘连需进一步研究。

Clinical Analysis of FIysteroscopic Diagnosis and Treatment of 48 Cases of Severe Intrauterine Adhesion

Objective Analyze the clinical outcome of the severe intrauterine adhesions,to investigate the methods of prevent adhesion again after trans cervical resection of adhesion. Methods Retrospective study was employed to analyze the clinical data of 48 patients with severe intrauterine adhesion which underwent hysteroscopic transcervical resect ion of adhesion. Results Clinical manifestation of 87.5%（42/48）of patients with intrauterine adhesions was abnormal menstruation. More intrauterine surgical procedures led to a greater possibility of severe intrauterine adhesion（P〈0. 05）. Menstruation recovery of 48 patients is known by the outpatient follow-up, 3 month after the operation, hysteroscopy was used to follow up the recovery with intrauterine adhesion, the over all effective rate was 79.1%（38/48）. Patients with severe degree of intrauter ineadhesion before operation recovered with poorer therapeutic efficacy（P〈0.05）. Conclusion Hysteroscopic adhesiolysis is an effective method of choice for treating intrauterine adhesion. Applying of placing a balloon and a copper intrauterine device inside the uterus, artificial cycle after the operation can can efficiently prevent adhesion, treatment after surgery of how to prevent adhesion again especially for Severe intrauterine adhesions after operation needs to be studied further.