雌激素在宫腔镜手术粘连预防中的应用效果探讨

摘要

目的：探讨雌激素在宫腔镜分离后宫腔粘连的疗效与安全性。方法选择该院2010年1月—2014年1月收治入院的宫腔镜电切术后患者200例，随机分为观察组和对照组,每组100例。对照组术后宫腔内放置金属圆形IUD，而观察组口服戊酸雌二醇预防宫腔粘连。定期随诊，治疗结束后复查肝功，并在宫腔镜下行取环术。结果两组患者治疗后肝功能均无异常，粘连治疗前镜下宫腔狭窄呈条状，宫腔两侧壁与双侧宫角及输卵管口均消失，部分宫腔闭锁严重的广泛粘连使宫腔形态完全消失。治疗后基本恢复正常；观察组子宫内膜厚度0.8～1.2、月经恢复正常88例、月经量少8例、恢复妊娠12例，对照组宫内膜厚度0.4～1.1 cm、月经恢复正常69例、月经量少23例、恢复妊娠8例，两组比较差异有统计学意义（P<0.05）。结论雌激素预防宫腔镜分离后宫腔粘连的疗效好,预防范围广,安全性强,值得推广应用。%Objective To evaluate the safety and efficacy of estrogen in hysteroscopic intrauterine adhesion separation. Methods 200 cases after hysteroscopic surgery admitted in our hospital from January 2010 to January 2014 were randomly divided into the observation group and the control group with 100 cases in each. For the prevention of intrauterine adhesions, the control group was given metal circular IUD placing in the uterine cavity, and the observation group was given estradiol valerate orally. The patients were followed up regularly. And liver function of the patients was detected after the treatment; IUD was removed in hysteroscopy. Results After treatment, the liver function of the two groups of patients showed no abnormality. Before the treatment of intrauterine adhesions, the uterine cavity was in the shape of narrow strip, both sides of the uterine cavity wall and bilateral uterine horn and the fallopian tube were all disappeared, uterine cavity shape disappeared completely due to extensive adhesion of severe part uter-ine atresia. After treatment, the above symptoms returned to normal basically. In the observation group, the endometrial thickness was 0.8~1.2, menstruation returned to normal in 88 cases, 8 cases with few amount of menstruation, 12 cases recovered pregnan-cy;in the control group, the endometrial thickness was 0.4~1.1cm, menstruation returned to normal in 69 cases, 23 cases with few amount of menstruation, 8 cases recovered pregnancy, the differences between the two groups were statistically significant(P<0.05). Conclusion Estrogen has good effect on preventing the intrauterine adhesions after hysteroscopy separation with wide prevention range and high safety, which is worthy of popularization and application.