自交联透明质酸钠预防宫腔镜术后宫腔粘连的效果观察

目的 探究自交联透明质酸钠预防宫腔镜电切术后宫腔粘连的临床疗效。方法 选取2015年1月~2017年1月就诊于惠州市中心人民医院及经我院临床确诊后需进行宫腔镜电切术治疗的150例患者为研究对象，按随机数字法分为三组，每组50例，A组术后宫腔内注射自交联透明质酸钠3 ml，B组术后宫腔内注射普通医用透明质酸钠3 ml，C组为空白对照组。术后1、3个月门诊行宫腔镜复查。观察三组患者术后宫腔粘连情况、首次月经复潮时间、阴道流血持续时间及相关并发症。结果 术后1个月A和B两组患者宫腔粘连发生率分别为4.00%（2/50）和20.00%（10/50），均低于C组的38.00%（19/50），差异具有统计学意义（P＜0.05）。术后3个月A和B两组宫腔粘连发生率分别为6.00%（3/50）和24.00%（12/50），均明显低于C组的44.00%(22/50)，差异有统计学意义（P＜0.05）。A、B两组治疗后首次月经复潮时间、术后阴道流血持续时间、及术后2 h阴道出血量均低于C组，差异有统计学意义（P＜0.05）。三组术后临床不良反应率C组42.00%（21/50），高于A组14.00%（7/50）及B组22.00%（11/50），差异有统计学意义（P＜0.05）。结论 宫腔镜电切术后患者给予自交联透明质酸钠可有效降低宫腔镜术后宫腔粘连的发生率，改善患者术后阴道出血及月经情况，降低术后临床不良反应发生率。

Effect of Self-crosslinking Sodium Hyaluronate on Prevention of Intrauterine Adhesion after Hysteroscopic Surgery

Abstract:Objective To investigate the clinical efficacy of self-crosslinking sodium hyaluronate in preventing intrauterine adhesion after hysteroscopic electric resection.Methods From January 2015 to January 2017,150 patients who were treated in Huizhou Central People's Hospital and undergoing hysteroscopic electric resection after clinical diagnosis in our hospital were selected as subjects.They were divided into three groups according to random number method.50 patients in each group, group A was intrauterine injection of self-crosslinking sodium hyaluronate 3 ml,group B was intrauterine injection of ordinary medical sodium hyaluronate 3 ml,group C was a blank control group.Hysteroscopy was performed in the outpatient clinic 1 and 3 months after surgery.The postoperative intrauterine adhesion,the first menstrual re-tidal time,the duration of vaginal bleeding and related complications were observed.Results The incidence of intrauterine adhesion in group A and group B was 4.00%(2/50)and 20.00%(10/50),respectively,one month after surgery,which was lower than 38.00%(19/50)of group C,the difference was statistically significant(P<0.05).3 months after operation,the incidence of intrauterine adhesion in group A and group B was 6.00%(3/50)and 24.00%(12/50),respectively,which was significantly lower than 44.00%(22/50)of group C,the difference was statistically significant(P<0.05).The first menstrual re-tidal time,postoperative vaginal bleeding duration,and 2 h postoperative vaginal bleeding were significantly lower in group A and group B than in group C,the difference was statistically significant(P<0.05).The clinical adverse reaction rate in group C was 42.00%(21/50),which was higher than that in group A 14.00%(7/50)and group B 22.00%(11/50),the difference was statistically significant(P<0.05).Conclusion Patients underwent hysteroscopic resection after self-crosslinking sodium hyaluronate can effectively reduce the incidence of intrauterine adhesion after hysteroscopic electric surgery,improve postoperative vaginal bleeding and menstrual conditions,and reduce the incidence of postoperative clinical adverse reactions.