宫腔镜为主的综合治疗在宫腔粘连宫腔重建中的应用

目的探讨以宫腔镜为主的综合治疗在宫腔粘连病例宫腔重建中的应用价值。方法回顾性分析125例宫腔粘连病例以宫腔镜手术为主的综合治疗重建宫腔的疗效。结果125例宫腔粘连病例轻度粘连82例,中度粘连23例,重度粘连20例。124例分离1次成功重建宫腔,1例分次手术。术后106例恢复正常月经,占85%(106/125);10例月经改善,占8%(10/125);9例月经无改善或仍闭经,占7%(9/125)。术后宫腔再粘连12%(15/121)。术后妊娠率48%。无手术并发症。结论宫腔镜对于不同程度宫腔粘连的宫腔重建微创有效,宫腹腔镜联合术是手术安全成功的保障;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利于预防术后再粘连。

Combined therapy with a primary of hysteroscopy in re-establish of uterine cavity for intrauterine adhesion cases

Objective It is to approach the value of combined therapy with a primary of hysteroscopy in re-establish of uterine cavity for intrauterine adhesion cases. Methods A retrospective review of 125 intrauterine adhesion cases by the combined therapy with a primary of hysteroscopy in re-establish of uterine cavity was performed. Results Intrauterine adhesion with mild, moderate and severe grade were found 82 cases, 23 cases and 10 cases respectively. 124 cases were detached complete in once operation and 1 case was operated twice. 106 cases menstruation returned to normal in 85 % of the 125 patients, 10 cases menstruation improved in 8 % of the 125 patients, and 9 cases menorrhea continued and hypomenorrhea remained in 7 % of the 125 patients. The postoperative pregnancy rate was 48 %. There were no operative complications in the study. Conclusion It is micro traumatic and effective for patients with different degree intrauterine adhesion to choose hysteroscopy in re-establish of uterine cavity, and combined with laparoscopy is the key to the operation safety and success. Periodic treatment of estrogen and progestogen can facilitate to repair endometrium, and combined with suitable IUD placement is beneficial to prevent the postoperative re-adhesion.