宫腔镜为主的综合治疗在中、重度宫腔粘连中的应用

目的:探讨以宫腔镜为主的综合治疗在中、重度宫腔粘连病例中的应用价值.方法:回顾性分析62例中、重度宫腔粘连病例以宫腔镜手术为主的综合治疗的疗效.结果:54例分离1次成功重建宫腔,8例分次手术重建宫腔.术后30例恢复正常月经,占48.4％(30/62)；23例月经改善,占37.1％(23/62)；9例月经无改善或仍闭经,占14.5％(9/62).8例术后宫腔再粘连12.9％ (8/62).结论:宫腔镜对于中、重度宫腔粘连的治疗是最有效的.使用宫腔镜联合超声是手术安全成功的保障,宫腔镜术后宫腔内注入几丁糖后宫腔持续放置Foils导尿管,术后的雌孕激素周期治疗促进子宫内膜修复、宫腔放置合适的宫内节育器三个月以上以及每月宫腔气囊扩张术,均有利于预防术后宫腔再粘连.

Hysteroscopy-based comprehensive therapy in the treatment of mild and severe intrauterine adhesion

Objectives： To explore on the application value of hysteroscopy-based comprehensive therapy in the treatment of mild and severe intrauterine adhesion.Methods： A retrospective study was made on 62 intrauterine adhesion patients to evaluate their therapeutic effects with the hysteroscopy-based comprehensive therapy.Results： Fifty-four patients showed successful reconstruction of uterus after one separation,while 8 cases had uterus reconstruction after several surgical procedures.Normal menstruation was reported by 30 patients after the surgery,accounting for 48.4% of all patients;23 patients reported improved menstruation（37.1%）;9 patients showed no sign of improvement（14.5%） and 8 patients were again found to have adhesion（12.9%）.Conclusion： Hysteroscopy is very effective in the treatment of mild and severe intrauterine adhesion.Hysteroscopy combined with ultrasound guarantee the safety of the surgery.The prevention against postoperative adhesion can be realized by injection of chitosan,placement of Foils urinary catheter,administration of estradiol and progesterone,placement of IUC for 3 months,and monthly uterus balloon dilation.