戊酸雌二醇预防宫腔镜术后宫腔粘连研究

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1、戊酸雌二醇预防宫腔镜术后宫腔粘连研究作者：熊小娟,胡盛桂,雷美云单位：1九江市妇幼保健院江西九江；2黄岗市龙感湖农场医院湖北黄岗【摘要】目的：评价戊酸雌二醇用于宫腔镜术后防止宫腔粘连的效果。方法：57例宫腔粘连及22例子宫纵隔患者行宫腔镜检查和治疗后，随机分为两组，研究组（50例）宫腔持续放置Foley尿管1周，对照组（29例）宫腔放置宫内节育器3个月，两组术后毎日加用戊酸雌二醇1～4mg口服，后半周期加用黄体酮行人工周期治疗3个月，术后给予抗生素预防感染3d。结果：79例患者术后随访1～36个月，所有患者均无明显胃肠道副反

2、应，复查肝功能正常。研究组月经恢复率96.0%,有效宫内妊娠率52.9%，1例宫外孕，2例早期自然流产。对照组月经恢复率93.1%，1例早期自然流产。两组月经恢复率比较p>0.05,差异无统计学意义。结论：戊酸雌二醇用于宫腔镜术后防止宫腔粘连是有效的药物选择，同时宫腔持续放置Foley尿管有协同作用，不孕患者可首选。【关键词】戊酸雌二醇；宫腔粘连；宫腔镜；Foley尿管Effectofestradiolvalerateinpreventingintrauterineadhesionsinpatientsconducte

3、dhysteroscopypostoperatively　　XIONGXiao-juan；HUSheng-gui；LEIMei-yun　　1.JiujiangCityWomen'sandChildren'sHospital,Jiujiang,Jiangxi332000,China;2.LongganhuFarmHospital,Huanggang,Hubei436100,ChinaABSTRACTOBJECTIVE：Toevaluateeffectofestradiolvalerateinpreventingintraute

4、rineadhesionsinpatientsconductedhysteroscopypostoperatively.METHOD：57patientswithintrauterineadhesionsand22patientsofuterineseptumtreatedbyhysteroscopyweredividedintotwogroups.50patientsintrialgroupwereplacedintrauterineFoleyurinarycatheterforoneweekwhile29patients

5、incontrolgroupwereplacedintrauterinedeviceforthreemonths.Patientsinthetwogroupstookestradiolvalerate1～4mgperday.Progesteronewasaddedonthesecondstageforthree-monthartificialcyclictherapy.Allpatientsweregivenantibioticsfor3dayspostoperatively.RESULTS：Nogastrointestin

6、alreactionsoccurredandliverfunctionexaminationwasnormalinthefollow-upforthe79patients.Inthetrialgroup,therewasamenopauserecoveryrateof96.0%andsuccessfulintrauterinepregnancyrateof52.9%.Therewasonecaseofectopicpregnancyandtwoearlyabortions;Inthecontrolgroup,menopaus

7、erecoveryratewas93.1%andonenaturalabortion.Nostatisticaldifferenceinmenopauserecoveryratepresentedbetweenthetwogroups(p>0.05).CONCLUSION：Estradiolvalerateisaneffectivemedicineforpreventionofpositiveintrauterineadhesions.Foleycatheterhassynergisticeffectandcanbef

8、irstchoiceforinfertilewomen.KEYWORDSestradiolvalerate;intrauterineadhesion;hysteroscope;Foleycatheter宫腔镜下切除子宫纵隔和分离宫腔粘连已成为此类疾病的常规和标准术式，但术后宫腔有再粘连现象