[1]庞琴霞,柳州*,王鹰,等.宫腔镜下粘连分离术后放置可吸收生物医用膜 在预防重度宫腔粘连复发中的应用[J].中国计划生育和妇产科,2018,(8):30-32,36.
　PANG Qin-xia,LIU Zhou*,WANG Ying,et al.Application of absorbable biological membrane in prevention of recurrence of severe intrauterine adhesions after hysteroscopic adhesions surgery[J].Chinese Journal of Family Planning & Gynecotokology,2018,(8):30-32,36.
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宫腔镜下粘连分离术后放置可吸收生物医用膜 在预防重度宫腔粘连复发中的应用
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《中国计划生育和妇产科》[ISSN:1674-4020/CN:51-1708/R]

卷:
期数:
2018年8期
页码:
30-32,36
栏目:
论著与临床
出版日期:
2018-08-25

文章信息/Info

Title:
Application of absorbable biological membrane in prevention of recurrence of severe intrauterine adhesions after hysteroscopic adhesions surgery
作者:
庞琴霞; 柳州*; 王鹰 ; 唐英
上海市浦东新区周浦医院妇产科
Author(s):
PANG Qin-xia; LIU Zhou*; WANG Ying; TANG Ying
Department of Obstetrics and Gynecology，Zhoupu Hospital of Pudong New District,Shanghai 201318,P.R.China
关键词:
重度宫腔粘连; 宫腔镜; 可吸收生物医用膜; 宫内节育器; 复发
Keywords:
severe intrauterine adhesions; hysteroscopy; absorbable biomedical membrane; intrauterine device; recurrence
分类号:
R 711.74
摘要:
目的探讨宫腔镜下粘连分离术后放置可吸收生物医用膜包裹宫内节育器在预防重度宫腔粘连（intrauterine adhesions, IUA）患者术后复发的疗效。方法选取上海市浦东新区周浦医院妇产科2012年1月至2016年6月收治的108例重度IUA患者为研究对象，按照随机数字表法将患者分为两组，所有患者均于宫腔镜下粘连分离术后即刻放置导尿管至术后第8 d，导尿管取出后，研究组(54例)宫内放置可吸收生物医用膜包裹宫内节育器，对照组（54例）宫内放置宫内节育器。比较两组患者术后3个月各项指标。结果研究组治疗总有效率（9074 %）明显高于对照组（7593 %），且月经改善率（8519 %）亦高于对照组（5741 %），差异均有统计学意义（P<005）；研究组宫腔容积、子宫内膜厚度及血流指数［（442±029）cm3、(855±103）mm、（2814±375）］均显著高于对照组［（385±038)cm3、(718±125)mm、(2447±397）］，差异均有统计学意义（P<005）。结论宫腔镜下粘连分离术的重度IUA患者，术后放置可吸收生物医用膜包裹宫内节育器能够明显改善患者的临床疗效，有助于预防IUA复发，值得临床应用。
Abstract:
ObjectiveTo investigate the effect of absorbable membrane-embedded intrauterine device in the prevention of adhesion recurrence after hysteroscopic adhesions surgery in patients with severe intrauterine adhesions. MethodsFrom January 2012 to June 2016 totally 108 severe intrauterine adhesions cases in Zhoupu Hospital of Pudong New District were selected. All cases were placed the Foley balloon catheter immediately until the eighth day after hysteroscopic adhesions surgery. They were divided into two groups according to the random number table after the catheter removed , the study group(54 cases) underwent absorbable membrane-embedded intrauterine device, and the control group(54 cases) was given intrauterine device. After 3 months, two groups of patients were compared in different indexes. ResultsThe total effective rate of the study group(9074 %) was significantly higher than that of the control group(7593 %), and the menstrual improvement rate(8519 %) was also higher than that of the control group(5741 %), which showed that the differences were statistically significant(P<005). The uterine cavity volume, endometrial thickness and blood flow index in the study group［(442±029)cm3，（855±103）mm，（2814±375）］ were significantly higher than those in the control group［（385±038）cm3，（718±125）mm，（2447±397）］, which showed that the differences were statistically significant(P<005). ConclusionPlacing absorbable membrane-embedded intrauterine device after hysteroscopic adhesions surgery in patients with severe intrauterine adhesions can significantly improve the clinical effects, which can prevent the recurrence of intrauterine adhesions, thus is worthy of clinical application.

参考文献/References:

［1］AMER M I, OMAR O H, HAMED M E, et al. Subendometrial blood flow changes by 3-dimensional power Doppler ultrasound after hysteroscopic lysis of severe intrauterine adhesions:preliminary study ［J］. Journal of Minimally Invasive Gynecology, 2015, 22(3): 495-500. ［2］XIAO Songshu, WAN Yajun, XUE Min, et al. Etiology, treatment, and reproductive prognosis of women with moderate-to-severe intrauterine adhesions ［J］. International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics, 2014, 125(2): 121-124. ［3］LIN Xiao-na, ZHOU Feng, WEI Min-ling, et al. Randomized, controlled trial comparing the efficacy of intrauterine balloon and intrauterine contraceptive device in the prevention of adhesion reformation after hysteroscopic adhesiolysis ［J］. Fertility and Sterility, 2015, 104(1): 235-240. ［4］乔琳，何援利加用防粘连膜的综合方法治疗重度宫腔粘连的临床效果观察 ［J］实用妇产科杂志，2013，29（9）：686-690 ［5］何金华，席予凡不同方法在重度宫腔粘连治疗中的疗效观察 ［J］中国妇幼健康研究，2016，27（9）：1151-1152 ［6］REVAUX A, DUCARME G, LUTON D. Prevention of intrauterine adhesions after hysteroscopic surgery ［J］. Gynecologie, Obstetrique & Fertilite, 2008, 36(3): 311-317. ［7］黄玥，张蔚，王勇，等中重度宫腔粘连分离术后预防宫腔再粘连的临床效果观察 ［J］现代妇产科进展，2015，24（8）：583-585 ［8］CONFORTI A, ALVIGGI C, MOLLO A, et al. The management of Asherman syndrome: a review of literature ［J］. Reproductive Biology and Endocrinology, 2013, 11(1): 118. ［9］HEALY M W, SCHEXNAYDER B, CONNELL M T, et al. Preventative measures for intrauterine adhesions following hysteroscopy:a systematic review and meta-analysis［J］. Fertility and Sterility, 2015, 104(3): e172. ［10］秦琰，王蔼明宫腔粘连的治疗进展 ［J］生殖医学杂志，2015，24（1）：75-78 ［11］孟环宇，邝彪，杨沫，等宫腔粘连宫内防治装置的研究进展 ［J］现代妇产科进展，2015，24（12）：946-948 ［12］张玲玲，应小燕重度宫腔粘连的治疗进展 ［J］医学综述，2015，21（15）：2770-2772 ［13］CAI Hui-hua, QIAO Lin, SONG Kai-jing, et al. Oxidized, regenerated cellulose adhesion barrier plus intrauterine device prevents recurrence after adhesiolysis for moderate to severe intrauterine adhesions ［J］. Journal of Minimally Invasive Gynecology, 2017, 24(1): 80-88. ［14］陈莉，丁楠，梁仲珍，等宫腔粘连分离术后预防再次粘连的研究进展 ［J］现代妇产科进展，2017，26（5）：393-395 ［15］黄永辉，李大鹏，沈铁城，等聚L乳酸/β-磷酸三钙可吸收材料体内降解过程中的生物力学特性 ［J］中国组织工程研究，2011，15（42）：7851-7854

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备注/Memo

备注/Memo:
上海市浦东新区卫生系统重点项目基金资助（项目编号：PWZXK2017-14）;上海市浦东新区青年科技项目基金资助（项目编号：PW2017B-18）
更新日期/Last Update: 2018-08-25