宫腔镜下微型剪刀分离复发宫腔粘连的临床疗效观察

目的:分析评价宫腔镜下微型剪刀分离复发宫腔粘连的临床疗效。方法:选取宫腔镜电切术后1月复查发现再发宫腔粘连的患者65例,其中40例轻度粘连、25例重度粘连。患者均在门诊行宫腔镜下微型剪刀分离,术毕宫腔注入透明质酸钠凝胶,继续口服戊酸雌二醇周期治疗。术后2~3月复查宫腔镜同时再次分离粘连,进行疗效评价。术后3月期间观察子宫内膜厚度。结果:术后3月,轻度和重度宫腔粘连患者的总有效率分别为92.5%和84%。轻度粘连组术后第2月与第3月的有效率比较,差异有统计学意义(P0.05);中度粘连组比较,差异亦有统计学意义(P0.05)。术后3月,两组患者的子宫内膜厚度均增加,两组比较差异有统计学意义(P0.05);且每组的组间不同时间段内膜厚度比较,差异也有统计学意义(P0.05)。结论:重复宫腔镜下微型剪刀分离宫腔复发粘连可作为宫腔镜电切分离粘连术后的辅助手段,提高治疗效果。

Clinical observation of using micro scissors to separate recurrent intrauterine adhesion under hysteroscopy

Objective: To analyze the outcome of separation of recurrent intrauterine adhesion by micro scissors under hysteroscopy. Methods: Patients suffered recurrent intrauterine adhesion( IUA) within one month after IUA hysteroscopic electric surgery were divided into 2 groups according to the degree of adhesion. The patients were separated by micro scissors under hysteroscopy in outpatient,then combined with hyaluronan gel and estradiol valerate cycle treatment. This treatment was repeated at the second and third month,and the endometrial thickness was observed. Results: The total effective rates of 40 mild adhesion and 25 moderate adhesion cases were 92. 5% and 84% respectively after 3 months of operation. In mild adhesion group,the results in the second month and the third month had significant difference( P < 0. 05).There was no statistical difference in moderate one( P < 0. 05). Endometrial thickness increased within 3 months in two groups,there were significant difference( P < 0. 05). Conclusion: Micro scissors resection under hysteroscopy can be used as a method to improve the effect after hysteroscopic electric resection.