宫腔镜电切术后置环加人工周期预防宫腔粘连的疗效

目的:比较人工周期或节育器留置治疗及预防宫腔粘连(intrauterine adhesion,IUA)的疗效。方法:选择2008年3月～2011年3月做宫腔粘连电切术(TCRA)、子宫黏膜下肌瘤电切术(TCRM)和子宫内膜多发性息肉电切术(TCRP)的患者,比较无处理组(A组)、置环组(B组)及置环加人工周期组(C组)的月经量恢复及宫腔镜下宫腔情况和妊娠情况。结果:置环及置环加人工周期A组出现不孕及月经量过少、单纯月经过少和闭经以及周期性腹痛的患者多于B组和C组,而C组最少(P<0.05);B组、C组宫腔粘连的发生率小于A组(P<0.05),而C组更低(P<0.05);术后半年随访A组妊娠率低于B组和C组(P<0.05),而C组高于B组(P<0.05)。结论:置环加人工周期对宫腔电切术后宫腔粘连治疗效果明显。

The effect of intrauterine device and artificial menstrual cycle to prevent intrauterine adhesion after hysteroscopic electrosurgery

Objective:To compare the using of artificial menstrual cycle or intrauterine device to treat and prevent intrauterine adhesion(IUA). Methods:All of 90 cases with IUA whom underwent TCRA,TCRM and TCRP from March 2008 to March 2011 were divided into non-treated group(Group A),intrauterine device group(Group B) and intrauterine device + artificial menstrual cycle group(Group C).The change of menstrual quantity and uterine cavity and pregnancy were observed. Results:The cases of sterility and mild menses,pure mild menses,amenorrhea in group A were more than that in group B and group C,and those in group C were the least,the differences were significant(P<0.05);The rates of adhesion in group B and C were less than that in group A,and it in group C was the least,the differences were significant(P<0.05);The pregnancy rate was the highest in group C,higher in group B than in group A(P<0.05). Conclusion:Combination of artificial menstrual cycle and intrauterine device is effective for intrauterine adhesion.