宫腔镜下持续放置水囊联合大剂量雌激素对宫腔粘连分离术患者子宫内膜功能恢复的影响

目的观察宫腔镜下持续放置水囊联合大剂量雌激素治疗对宫腔粘连分离术患者子宫内膜功能恢复的影响。方法回顾性分析2019年1~12月海南西部中心医院收治的60例宫腔粘连分离术患者的病例资料。所有患者均给予宫腔镜下持续放置水囊,根据治疗方案的不同分为观察组(n=30)和对照组(n=30),分别给予大剂量雌激素治疗与常规剂量雌激素治疗。比较2组患者激素受体水平及子宫内膜厚度变化情况,随访患者月经恢复正常情况及妊娠情况,记录用药不良反应。结果观察组患者腺上皮及间质细胞雌激素受体(ER)(10.86±1.36)、(7.89±1.53)]、孕激素受体(PR)(8.92±1.36)、(9.87±1.27)U/L]水平均明显高于对照组(9.15±1.26)、(6.12±1.06)、(7.12±1.24)、(8.42±1.25)U/L],差异有统计学意义(P<0.05)。2组患者治疗后3、6个月子宫内膜厚度均较治疗前明显降低,且观察组(5.46±1.24)、(5.12±0.24)mm]明显低于对照组(6.04±1.05)、(5.69±0.31)mm],差异有统计学意义(P<0.05)。观察组患者月经恢复正常率(76.7%)和临床妊娠率(53.3%)均明显高于对照组(46.7%、30.0%),差异有统计学意义(P<0.05)。2组患者不良反应发生率比较(10.0%vs.13.3%),差异无统计学意义(P>0.05)。结论宫腔粘连分离术患者行宫腔镜下持续放置水囊联合大剂量雌激素治疗,对患者子宫内膜功能恢复及月经恢复正常有促进作用,有利于提高临床妊娠率,值得临床推广应用。

Effects of continuous placement of water capsule combined with large dose of estrogen under hysteroscopy on endometrial functional recovery in patients undergoing intrauterine adhesion separation.

Objective To observe the effect of continuous placement of water capsule under hysteroscopy combined with large dose estrogen on endometrial function in patients with uterine adhesions separation.Methods From January to December 2019,the case data of 60 patients with intrauterine adhesions dissection admitted to Hainan Western Central Hospital were retrospectively analyzed,all patients were given continuous placed under hysteroscopy water sac,according to the different can be divided into the observation group(n=30)and control group(n=30),were given high doses of estrogen therapy and routine dose of estrogen therapy.The hormone receptor level and endometrial thickness of the two groups were compared.The normal menstruation and pregnancy status of the patients were followed up,and adverse drug reactions were recorded.Results The levels of estrogen receptor(ER)(10.86±1.36),(7.89±1.53)U/L]and progesterone receptor(PR)(8.92±1.36),(9.87±1.27)U/L]of glandular epithelium and stromal cells in the observation group were significantly higher than those in the control group(9.15±1.26),(6.12±1.06),(7.12±1.24),(8.42±1.25)U/L],the differences were statistically significant(P<0.05);the endometrial thickness of the two groups after treatment was significantly lower than that before treatment,and the observation group(5.46±1.24),(5.12±0.24)mm]was significantly lower than the control group(6.04±1.05),(5.69±0.31)mm],the difference was statistically significant(P<0.05).The menstrual recovery rate(76.7%)and clinical pregnancy rate(53.3%)in the observation group were significantly higher than those in the control group(46.7%,30.0%),the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(10.0%vs.13.3%)(P>0.05).Conclusion Continuous placement of water capsule under hysteroscopy combined with large dose estrogen therapy in patients undergoing intrauterine adhesion separation surgery can promote the recovery of endometrial function and normal menstruation,which is beneficial to improve the clinical pregnancy rate,and can be widely promoted in clinical practice.