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目的:比较Ⅱ度宫腔粘连(intrauterine adhesion,IUA)宫腔镜手术后放置和不放置宫腔球囊2种治疗方案的疗效。方法:选择2014年9月至2016年3月就诊于首都医科大学附属复兴医院宫腔镜中心,经宫腔镜检查确诊为Ⅱ度IUA患者80例,随机分为2组:A组40例,行宫腔镜宫腔粘连电切术(transcervical resection of adhesion,TCRA)后予雌、孕激素人工周期治疗2个月;B组40例,TCRA术后宫腔内放置Foley球囊并注水4 m L,留置5 d,术后予雌、孕激素人工周期治疗2个月。所有患者均于术后1、3个月行宫腔镜二探,观察2组IUA复发情况,并评估月经改善情况,从而评价2种治疗方案的疗效。结果:术后1个月复查A组13例(32.5%)膜样粘连,B组9例(22.5%)膜样粘连,2组之间无统计学差异(P=0.317);术后3个月复查A组及B组均无粘连发生;术后3个月A组月经改善率86.94%;B组月经改善率90.91%,2组比较差异无统计学意义(P=1.000)。结论:对于Ⅱ度IUA患者,TCRA术后可不予放置Foley球囊预防粘连复发,仅通过术后宫腔镜二探即可预防粘连复发。
Objective: To compare the curative effect of intrauterine adhesion (IUA) intrauterine adhesion (IUA) with and without intrauterine adhesion after intrauterine adhesion (IUA). Methods: From September 2014 to March 2016, we visited the hysteroscopy center of Fuxing Hospital Affiliated to Capital Medical University from September 2014 to March 2016. Eighty IUA patients with grade II were confirmed by hysteroscopy. They were randomly divided into two groups: 40 cases in group A, The patients were treated with estrogen and progesterone for 2 months after transcervical resection of adhesion (TCRA). In group B, Foley balloon was placed in the uterine cavity and infused 4 ml , Retained for 5 days, postoperative estrogen and progesterone artificial period of treatment for 2 months. All patients underwent hysteroscopy at 1 and 3 months after operation to observe the recurrence of IUA in two groups and evaluate the improvement of menstruation so as to evaluate the efficacy of the two treatment regimens. Results: Thirteen cases (32.5%) had membranous adhesions in group A and 9 cases (22.5%) in group B. There was no significant difference between the two groups (P = 0.317) There was no adhesions occurred in group A and group B. The improvement rate of menstruation in group A was 86.94% at 3 months. The improvement rate of group B was 90.91%. There was no significant difference between group A and group B (P = 1.000). Conclusion: For patients with grade Ⅱ IUA, Foley balloon can be used to prevent the adhesion recurrence after TCRA, and the recurrence of adhesion can be prevented only by the second hysteroscopy.