雌孕激素序贯疗法预防宫腔镜下子宫纵隔电切术后宫腔粘连的价值探讨

目的:观察宫腔镜下子宫纵隔电切术的疗效,评价术后应用雌孕激素序贯疗法预防宫腔粘连的价值.方法:选取子宫纵隔患者60例,随机分为对照组和观察组,各30例.2组患者均行腹腔镜监视下宫腔镜子宫纵隔电切术,对照组术后放置宫内节育器(金属圆环);观察组放置宫内节育器(金属圆环),并采用雌孕激素序贯人工周期疗法.所有患者于术后3个月行宫腔镜复查,比较2组宫腔粘连情况;继续随访至术后1年,比较2组患者妊娠及月经情况.结果:所有患者均顺利完成手术,无明显并发症发生.2组患者术后3个月宫腔粘连率差异无统计学意义(P>0.05);2组术后1年经期紊乱、经量增多及妊娠率差异亦均无统计学意义(P>0.05).结论:宫腔镜下子宫纵隔电切术安全有效,能有效提高患者妊娠率,但术后应用雌孕激素序贯疗法预防宫腔粘连未见明显价值.

Effect of the sequential estrogen and progestogen therapy on preventing the intrauterine adhesion after hysteroscopic uterine septum resection

Objective:To observe the effects of hysteroscopic uterine septum resection,and evaluate the value of sequential estrogen and progestogen therapy on preventing the postoperative intrauterine adhesion. Methods:Sixty patients with uterine mediastinum were randomly divided into the control group and observation group ( 30 cases each group ) . Two groups were treated with hysteroscopic uterine septum resection. The intrauterine device in two groups were placed after operation,and the observation groups were treated with sequential estrogen and progestogen artificial cycle therapy. All patients were reexamined using hysteroscopy after 3 months of operation, and the intrauterine adhesion between two groups were compared. All patients were followed up for 1 year, and the pregnancy and menstrual condition between two groups were compared. Results:All operations were successfully completed, and no obvious complication was found in two groups. The difference of the intrauterine adhesion after 3 months of operation between two groups was not statistically significant(P>0. 05). After 1 year of operation,the differences of the rates of menstrual disorder,profuse menstruation and pregnancy between two groups were not statistically significant(P>0. 05). Conclusions:The hysteroscopic uterine septum resection is safe and effective, which can effectively improve the pregnancy rate. The effect of sequential estrogen and progestogen therapy on preventing the postoperative intrauterine adhesion is not obvious.