透明质酸钠凝胶宫腔注射联合去氧孕烯炔雌醇口服预防人流术后宫腔粘连

目的 研究透明质酸钠凝胶宫腔注射联合去氧孕烯炔雌醇口服预防人流术后宫腔粘连.方法 选取2012年6月～ 2013年6月笔者医院已行人流手术患者610例随机分为4组,予益母草冲剂口服同时Ⅰ组（150例）予透明质酸钠凝胶2ml宫腔注射.Ⅱ组（152例）予去氧孕烯炔雌醇片1片/天口服,连服21天.Ⅲ组（153例）予透明质酸钠凝胶2ml宫腔注射联合去氧孕烯炔雌醇片1片/天口服,连服21天.Ⅳ组（155例）未做上述处理.观察4组患者人流术后宫腔积液、周期性腹痛、月经过少或闭经情况.结果 宫腔积液发生率,Ⅰ、Ⅲ组与Ⅱ、Ⅳ组相比较,差异有统计学意义（P＜0.05）.周期性腹痛发生率,Ⅲ组与Ⅱ、Ⅳ组比较,差异有统计学意义（P＜0.05）.月经过少或闭经的发生率,Ⅲ组与Ⅰ、Ⅳ组,Ⅱ组与Ⅳ组相比较,差异有统计学意义（P＜0.05）.结论 透明质酸钠凝胶宫腔注射联合去氧孕烯炔雌醇片口服有利于人流术后宫腔积血的排出,减少宫腔积液形成,促进子宫内膜修复,可有效防止宫腔粘连的发生.

Prevention of Intrauterine Adhesions after Induced Abortion by Intrauterine Injection of Sodium Hyaluronate Gel and Oral Desogestrel Ethinylestradiol

Objective To study on the prevention of intrauterine adhesions after induced abortion by intrauterine injection of sodium hyaluronate gel and oral desogestrel ethinylestradiol.Method Totally 610 cases of patients,who were finished induced abortion operation in our hospital from June 2012 to June 2013,were selected and divided into four groups in random.Patients of 150 cases in group Ⅰ got intrauterine injection of 2 ml sodium hyaluronate gel after oral motherwort medicine.Patients of 152 cases in group Ⅱ got oral desogestrel ethinylestradiol （1 table per day,until 21 days） after oral motherwort medicine.Patients of 153 cases in group Ⅲ got intrauterine injection of 2 ml sodium hyaluronate gel and oral desogestrel ethinylestradiol （1 table per day,until 21 days）,after oral motherwort medicine.Patients of 155 cases in group Ⅳ got oral motherwort medicine.The situation of uterine cavity effusion,periodic abdominal pain,oligomenorrhea or amenorrhea of patients in these four groups were observed.Results There was significant difference in incidence of uterine cavity effusion between Group Ⅰ,Ⅲ and Group Ⅱ,Ⅳ （P ＜ 0.05） ; and it was also significantly different between Group Ⅲ and Group Ⅱ,Ⅳ in incidence of periodic abdominal pain （P ＜ 0.05） ; while,in incidence of oligomenorrhea or amenorrhea,the difference between Group Ⅲ and Group Ⅱ,Ⅳ was significant （P ＜ 0.05）,and the same phenomenon was found between Group Ⅱ and Group Ⅳ.Conclusion The postoperative treatment with intrauterine injection of sodium hyaluronate gel associated oral desogestrel ethinylestradiol is conducive to discharging uterine hemorrhag,reducing uterine cavity effusion,promoting restoration of the endometrium,and effectively preventing the intrauterine adhesions.