球囊子宫支架预防宫腔粘连术后再粘连形成的临床研究

目的探讨球囊子宫支架预防宫腔粘连术后再粘连形成及减少子宫出血的有效性。方法选取2010年3月～2013年3月浙江省人民医院妇科收治的宫腔粘连患者106例为研究对象,将其分为观察组和对照组,每组各53例。观察组给予宫腔镜下电切割术＋球囊子宫支架放置术＋宫内节育器放置术＋人工周期治疗,对照组给予宫腔镜下电切割术＋宫内节育器放置术＋人工周期治疗。术后1、3个月随访,均予宫腔镜检查,观察并比较两组宫腔形态恢复情况、术后出血量、月经恢复情况、再粘连发生情况及感染、子宫穿孔、大出血等并发症发生情况。结果研究组总有效率（92.45%）高于对照组（79.25%）,两组比较差异有统计学意义（P〈0.05）;治疗1、3个月后,研究组宫腔粘连率（20.75%、7.55%）低于对照组（33.96%、16.98%）,两组相比差异有统计学意义（P〈0.05）;研究组术后出血量及并发症总发生率[（121.37±24.19）mL、13.21%）]低于对照组[（198.61±29.37）mL、52.83%],两组相比差异有统计学意义（P〈0.05）;研究组月经恢复率（88.68%）高于对照组（66.04%）,两组相比差异有统计学意义（P〈0.05）。结论球囊子宫支架预防宫腔粘连术后再粘连形成效果显著,可有效预防宫腔粘连,减少子宫出血及并发症的发生。

Clinical study on Balloon endometrial bracket in the prevention of intrauterine adhesions postoperative adhesion formation

Objective To explore the clinical effects of balloon endometrial bracket in the prevention of intrauterine adhesions postoperative adhesion formation and reduction of the uterine bleeding. Methods 106 cases with intrauterine adhesions from March 2010 to March 2013 in Gynecology Department of Zhejiang Provincial People＇s Hospital were selected as study objects,they were randomly divided into study group and control group,with 53 cases in each group. Patients of the study group were given hysteroscopy cutting surgery,balloon uterine stent placement,intrauterine device placement surgery,and artificial cycle treatment; and patients of the control group were given the hysteroscopy cutting surgery,intrauterine device placement surgery,and artificial cycle treatment.All patients were followed-up 1 and 3 months after treatment and were given the hysteroscopy,the recovery of uterine cavity shape,Postoperative blood loss,menstruation recovery,intrauterine adhesions rate,infection,uterine perforation,bleeding and others complications of two groups were observed and compared. Results The total effective rate of study group（92.45%） was higher than that of the control group（79.25%）,the difference was statistically significant（P 0.05）. The intrauterine adhesions rate of study group（20.75%,7.55%） in 1 and 3 months after treatment were lower than those of the control group（33.96%,16.98%）,the differences of two groups were statistically significant（P 0.05）. The amount of bleeding and total incidence of complications of the study group [（121.37 ±24.19） mL,13.21%）] were lower than those of the control group [（198.61±29.37）mL,52.83%],the differences of two groups were statistically significant（P 〈0.05）; The menstruation recovery rate of the study group（88.68%） was higher that of the control group（66.04%）,the difference was statistically significant（P〈 0.05）. Conclusion Balloon endometrial bracket has a significant effect in the prevention of intrauterine adhesions postoperative adhesion formation,can effectively prevent intrauterine adhesions and reduce the amount of bleeding and total incidence of complications.