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目的探讨双腔导尿管联合赛必妥宫腔注射及宫血宁治疗中重度宫腔粘连的临床疗效。方法 93例中重度宫腔粘连患者经宫腔镜检查确诊后,随机分成对照组(术后采用戊酸雌二醇治疗,38例)和观察组(戊酸雌二醇治疗基础上加用双腔导尿管联合赛必妥宫腔注射及宫血宁,55例),定期随访观察术后宫腔形态形成、月经恢复、粘连复发及妊娠情况。结果观察组和对照组正常宫腔形成分别为74.54%、52.63%;月经改善率分别为85.45%、57.89%,无一例闭经;粘连复发率分别为18.18%、47.37%;术后妊娠率分别为52.73%、23.68%;上述各指标两组间比较差异均有统计学意义(P<0.05),两组无术后病死率及周期性腹痛。结论双腔导尿管联合赛必妥宫腔注射及宫血宁治疗中重度宫腔粘连分离术后可有效防止宫腔再粘连,促进月经恢复及妊娠率。
Objective To investigate the clinical efficacy of double-lumen catheter combined with intrauterine injection of Xetate and Gongxuening in treating moderate-severe intrauterine adhesions. Methods Ninety-three patients with moderate-to-severe uterine adhesions were diagnosed by hysteroscopy and randomly divided into control group (postoperatively treated with estradiol valerate, 38 cases) and observation group (treated with estradiol valerate plus double Cavity and catheter combined with cystine and uterine cavity injection Gongxingning, 55 cases), regular follow-up observation of postoperative uterine morphology, menstrual recovery, adhesions recurrence and pregnancy. Results The normal uterine cavity in the observation group and the control group were 74.54% and 52.63% respectively. The improvement rate of menstruation was 85.45% and 57.89% respectively, without amenorrhea. The recurrence rates of adhesion were 18.18% and 47.37% respectively. The postoperative pregnancy rates were 52.73% and 23.68% respectively. There was significant difference between the above two indexes (P <0.05). There was no postoperative mortality and recurrent abdominal pain in the two groups. Conclusions Dual-lumen catheter combined with intrauterine injection of cystine and Gongxuening can effectively prevent intrauterine adhesions and promote menstruation recovery and pregnancy rate after moderate and severe intrauterine adhesions separation.