宫腔粘连分离术后预防再粘连方法的疗效比较

目的 :总结宫腔粘连分离术后宫内节育环、INTERCEED防粘连膜+宫内节育器(Interceed)及球囊支架预防再粘连的疗效。方法:回顾性分析2010年1月至2013年12月收治的589例宫腔粘连分离术患者的临床资料,以术中宫腔放置节育器(IUD)为对照组(n=202),宫腔放置INTERCEED为观察组A(n=199),宫腔放置球囊支架为观察组B(n=188),术后3个月复查宫腔镜了解宫腔形态恢复情况及术后半年随访月经改善情况。结果:三组对轻中度宫腔粘连患者的有效率无明显差异(P0.05);观察组A、观察组B对重度宫腔粘连患者的有效率均明显高于对照组(P0.05);术后半年随访,观察组A、观察组B对月经量改善的有效率均明显高于对照组(P0.05)。结论:对于轻中度宫腔粘连患者,3种材料预防再粘连效果无明显差异,而对于重度宫腔粘连患者,INTERCEED与球囊支架均能显著减少术后再粘连的发生,效果均优于节育环,而INTERCEED与球囊支架无明显差异。

Comparison of Effect on Preventing Adhesion Recurrence after Transcervical Resection for Intrauterine Adhesions

Objective： To summarize the effects of intrauterine device （IUD）、Foley catheter and Interceed absorbable adhesion barrier on preventing adhesion recurrence after transcervical resection for intrauterine adhesions;Methods：The clinical data of 589 patients with intrauterine adhesions underwent transcervical resection from Jan 2010 to Dec 2013 were retrospectively studied. 202 cases palced with IUD as control group,199cases placed Interceed as the observation group A,and 188 cases placed Foley catheter uterine as the observation group B, the three group were reviewed hysteroscopy to understand uterine recovery after 3 months and menstruation after half year. Results： Patients with mild or moderate and IUA, the effective rate were no significant differences among the three groups （P〉0.05）. Patients with serious IUA,the effective rate in the observation group A and group B were significantly higher than that in the control group （P 〈 0.05）. The improving rate of menses in the observation group A and group B were significantly higher than that in the control group after postoperative six months. Conclusion： There are no differences between the three methods in patients with mild and moderate IUA,but in patients with serious IUA, Foley catheter and Interceed are superior to IUD for preventing re adhesions after hysteroscopic adhesiolysis.