摘要
目的探讨雌激素预处理对宫腔粘术后宫腔整复及内膜容受性的影响。方法收集拟行宫腔镜下宫腔粘连分离术(TCRA)治疗的中、重度宫腔粘连患者166例,将患者分为观察组和对照组,每组83例。观察组在TCRA术前口服戊酸雌二醇2个疗程,术后继续服用戊酸雌二醇人工周期2~3个疗程;对照组仅术后行人工周期2~3个疗程。比较两组患者术后月经、子宫内膜厚度、子宫动脉血流搏动指数PI和阻力指数RI、粘连复发及术后妊娠情况。结果术后3个月,观察组月经改善率高于对照组,总再粘连率低于对照组,子宫内膜厚度较对照组厚,PI、RI值降低优于对照组,差异有统计学意义(P<0.05)。两组患者术后妊娠率、活产率比较差异无统计学意义(P>0.05)。结论术前应用雌激素治疗可促进患者TCRA术后月经改善,减少粘连复发,改善内膜血供,提高内膜容受性,对临床治疗具有一定的指导意义。
Objective To investigate the effects of estrogen pretreatment on uterine cavity repair and endometrial receptivity after trascervical resection of adhesion.Methods 166 cases of moderate and severe intrauterine adhesions treated by TCRA were collected.Patients were randomly divided into observation group and control group,with 83 cases in each group.The observation group was treated with estradiol valerate before TCRA for two courses,and continued for 2~3 courses after TCRA;the control group only received treatment after TCRA.Comparison of menstruation,endometrial thickness,PI and RI,recurrence of adhesions and pregnancy between the two groups.Results Three months after the operation,the menstrual improvement rate of the observation group was higher than that of the control group,the total re-adhesion rate was lower than that of the control group,the endometrial thickness was thicker than that of the control group,and the PI and RI values were lower than that of the control group,with statistically significant difference(P<0.05).There was no significant difference in pregnancy rate and live birth rate between the two groups(P>0.05).Conclusion Preoperative application of estrogen therapy can improve the efficacy of TCRA,promote menstrual improvement,reduce adhesion recurrence,improve intimal blood supply,and improve intimal receptivity,which has certain guiding significance for clinical treatment.
作者
王宏琰
廖予妹
WANG Hong-yan;LIAO Yu-mei(Department of Gynecology and Obstetrics,the Second Affiliated Hospital of Zhengzhou university,Zhengzhou,Henan 450003)
出处
《智慧健康》
2020年第11期96-98,101,共4页
Smart Healthcare
基金
河南省卫生计生委科技攻关项目(No:201503084)
关键词
宫腔粘连
雌激素
宫腔镜下粘连分离术
Intrauterine adhesion
Estrogen
Transcervical resection of adhesion
作者简介
王宏琰(1992-),女,医师,硕士研究生,主要研究方向:妇科内分泌、妇科肿瘤;通讯作者:廖予妹(1964-),女,主任医师/教授,博士研究生,主要研究方向:妇科疾病。
