| 侯晓霞,吕淑兰,刘 晨,胡春艳,贾 亮,田燕妮,闫 坤.宫内节育器与宫腔支撑球囊联合应用治疗中重度宫腔粘连中的临床效果[J].,2020,(22):4335-4339 |
| 宫内节育器与宫腔支撑球囊联合应用治疗中重度宫腔粘连中的临床效果 |
| A Clinical Study on Intrauterine Contraceptive Device and Combined with Intrauterine Support Balloon in the Treatment of Moderate and Severe Intrauterine Adhesions |
| 投稿时间：2020-05-08 修订日期：2020-05-31 |
| DOI：10.13241/j.cnki.pmb.2020.22.030 |
| 中文关键词: 宫腔粘连 宫内节育器 宫腔支撑球囊 |
| 英文关键词: Intrauterine adhesions Intrauterine device Intrauterine support balloon |
| 基金项目:陕西省卫生健康委科研基金项目(2018D039)；西安市科技计划项目(2017117SF/YX001(3)) |
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| 中文摘要: |
| 摘要 目的：探讨宫内节育器与宫腔支撑球囊联合应用治疗中重度宫腔粘连的临床效果。方法：选择2016年12月至2019年8月于西安交通大学第一附属医院宫腔镜诊疗中心接受宫腔镜下中重度宫腔粘连分解术的患者共96例，采用随机对照表法将其分为两组。对照组48例，术后宫腔内放置宫内节育器(intrauterine contraceptive device，IUD)；研究组48例，术后放置宫腔支撑球囊(intrauterine support balloon，ISB)，3~5 d后更换为宫内节育器。两组术后均给予为期3月的人工周期治疗。术后1月，复查宫腔镜了解宫腔有无再粘连并取出宫内节育器，以此评估手术效果是否有效，术后3月时随访其月经来潮情况。统计比较两组术后5 d内阴道出血量、C反应蛋白水平、发热、下腹痛以及节育器或支持球囊有无脱落等情况，术后1月手术效果及术后3月月经恢复情况。结果：研究组的手术有效率及月经改善比例均显著高于对照组(P<0.05)，术后5 d内阴道出血量显著少于对照组(P<0.05)；下腹痛及球囊脱落事件发生率显著低于对照组(P<0.05)。两组在C反应蛋白水平、发热发生率对比无统计学差异(P>0.05)。结论：与单独使用宫内节育器相比，联合使用宫腔支撑球囊能提高中重度宫腔粘连分解手术有效率，改善月经，减少术后出血，不增加感染风险，但球囊易于脱落且会增加患者下腹疼痛。 |
| 英文摘要: |
| ABSTRACT Objective: To compare the effect of intrauterine contraceptive device and combined application of intrauterine support balloon in the treatment of intrauterine adhesion. Methods: A total of 96 patients who underwent hysteroscopic moderate and severe hysterectomy at the First Affiliated Hospital of Xi'an Jiaotong University from December 2016 to August 2019 were selected and randomized table method was used to divide them into two groups. In the control group, 48 cases was placed with intrauterine contraceptive device after operation, and 48 cases in the study group was replaced with an intrauterine contraceptive device after 3~5 days after the intrauterine support balloon was placed. The two groups were given artificial cycle treatment for 3 months after operation. Hysteroscopy was performed one month after the operation to check whether the uterine cavity was re-adhered and the intrauterine device was removed to evaluate whether the operation was effective. Follow-up of menstrual cramps at 3 months after surgery. Statistics were used to compare the amount of vaginal bleeding, C-reactive protein levels, fever, lower abdominal pain, and IUD or support balloon fall-off within 5 days after operation. The surgical effect at 1 month after operation and the menstrual recovery at 3 months after operation were compared between the two groups. Results: The operation efficiency of the research group was significantly higher than that of the control group (P<0.05), the number of menstrual improvement was significantly more than the control group (P<0.05), and the amount of vaginal bleeding within 5 days after surgery was significantly less than that of the control group (P<0.05). There was no difference in C-reactive protein level and fever rate between the two groups (P>0.05). The occurrence of lower abdominal pain and balloon exfoliation in the study group was significantly lower than that in the control group (P<0.05). Conclusion: Compared with the use of IUD alone, the combined use of uterine cavity support balloons after moderate and severe intrauterine adhesions can improve the efficiency of surgery, improve menstruation, reduce postoperative bleeding, and not increase the risk of infection, but the balloon Easily falls off and increases pain in the lower abdomen. |
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