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目的:观察透明质酸钠凝胶对重度宫腔粘连(IUA)分解术后再粘连状态的影响。方法:将2012年1月-2013年12月在某院经宫腔镜探查确诊为重度IUA患者126例分层随机分为观察组和对照组,对照组在重度IUA分离术后使用Forly球囊,观察组采用Forly球囊+医用透明质酸钠凝胶。通过二探法观察2组患者宫腔镜下所见粘连范围、类型、术后月经、妊娠情况以及通过三维彩超观察2组患者的子宫内膜情况等。结果:粘连分解术观察组手术总有效率为98.4%(62例),对照组总有效率为84.1%(53例)。观察组的月经改善情况、妊娠率和子宫内膜情况均优于对照组,差异均有统计学意义(P<0.05)。结论:重度IUA分解术后于宫腔内放置透明质酸钠凝胶可有效预防再粘连,促进术后子宫内膜生长,改善月经情况及提高妊娠率。
Objective: To observe the effect of sodium hyaluronate gel on the state of re-adhesion after severe intrauterine adhesions (IUA). Methods: One hundred and sixty-six patients with severe IUA who underwent hysteroscopy in a hospital from January 2012 to December 2013 were randomly divided into observation group and control group. The control group was treated with Forly balloon after severe IUA , The observation group used Forly balloon + medical sodium hyaluronate gel. Two groups of patients were observed by hysteroscopy in two groups of hysteroscopic adhesions seen in the scope, type, postoperative menstruation, pregnancy and three-dimensional ultrasound to observe the two groups of patients with endometrial conditions. Results: The operative total effective rate was 98.4% (62 cases) in the observation group and 84.1% (53 cases) in the control group. Menstrual improvement in the observation group, pregnancy rate and endometrial conditions were better than the control group, the difference was statistically significant (P <0.05). Conclusion: Intrauterine placement of sodium hyaluronate gel after severe IUA dissociation can effectively prevent re-adhesion, promote postoperative endometrial growth, improve menstrual status and improve pregnancy rate.