两种不同方法分离宫腔粘连的临床观察.doc

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1、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，对照组釆用宫腔镜下电切术。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)；月经改善总冇效率分别为81.3%(26/32)、80.0%(24/30)；宫腔粘连的复发率分别为15.6

2、%(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(P>0.05)。两组住院天数、手术费用、总费用比较差异有统计学意义(P〈0・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)-0070-04Clinicalobservationo

3、ftwodifferentmethodsofseparationofintrauterineadhesionsLONGWen-xiangYANGZhang-liLIRong-yingZHOUChun-huiAMaternalandChildCareServiceCentreofZhuzhouCityinHunanProvince,Zhuzhou412008,China[Abstract]ObjectiveToexploretheprognosisoftwodifferentmethodsofseparationofintrauterineadhe

4、sions.MethodsModeratelysevereintrauterineadhesionspatientswererandomlydividedintotwogroups,thestudygroup(32cases)weregivenwithmicroscissorsresectionunderhysteroscopy,thecontrolgroup(30cases)weregivenwithhysteroscopicelectricresection.Twogroupsofpatientsweretreatedwithsurgeryc

5、ombinedwithsodiumhyaluronateonintrauterineinjectionofestrogen,progesteroneandartificialcycletherapyfor3months;after1,3monthsforhysteroscopy;after6,18monthsrespectivelywerefollowedup1time・ResultsTheuterinemorphologyrecoveryrateofstudygroupandcontrolgroupwas90.6%(29/32),93.3%(2

6、8/30)respectively;menstrualimprovementrateswere81.3%(26/32),80.0%(24/30);recurrenceofintrauterineadhesionswere15.6%(5/32),13.3%(4/30);pregnancyratewas34.6%(9/26),27.3%(6/22)respectively;thetwogroupshadnostatisticaldifferenee(P>0.05)・Twogroupsofhospitalizationdays,operationcos

7、t,totalcosthadsignificantdifference(P<0.05).Thetwogroupshadnoobviousadversereactionandcomplicationofoperation.ConclusionTwodifferentmethodsofseparationofintrauterineadhesi（）nseffectshasnostatisticaldifferenee,microscissorsresectionunderhysteroscopyisworthyofclinicaltreatment.

8、［Keywords］Intranuterineadhesion;Hysteroscopy;Electrocision;Mioroscis