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目的评估重度宫腔粘连分离术后应用7～8mm宫腔镜定期监测在预防宫腔再粘连中所起的作用。方法回顾性分析浙江省宁波市第六医院2009年6月至2012年5月宫腔镜下重度宫腔粘连分离术102例患者的临床资料,术后宫腔先放置充水球囊后放IUD者53例为球囊放环组;闭经者术后每2周实施1次7～8mm宫腔镜监测,月结来潮者在月经干净3～7d监测1次宫腔粘连情况,共49例为宫腔镜监测组。观察宫腔再粘连情况,并跟踪月经改善及妊娠情况。结果术后3个月球囊放环组宫腔镜探查再次粘连率为26.42%,宫腔镜监测组为6.12%(P<0.01);两组月经改善情况分别为81.13%和95.92%(P<0.05);球囊放环组妊娠率33.96%,宫腔镜监测组妊娠率38.78%,差异无统计学意义(P>0.05)。结论重度宫腔粘连分离术后应用7～8mm宫腔镜定期监测可以有效预防再粘连,提高月经改善率,但未能显著提高妊娠率。
Objective To evaluate the role of hysteroscopy in the prevention of intrauterine reunion following the treatment of severe intrauterine adhesions. Methods The clinical data of 102 patients undergoing hysteroscopic severe intrauterine adhesions from June 2009 to May 2012 in the Sixth Hospital of Ningbo City, Zhejiang Province were retrospectively analyzed. After the uterus was placed in the water-filled balloon, IUD 53 cases were treated with balloon deconvolution; amenorrhea patients were observed with hysteroscopy 7 ~ 8mm every 2 weeks after operation, and those who had ectopic menstrual flow were observed for 1 ~ Endoscopy monitoring group. Observation of intrauterine re-adhesion, and follow-up to improve menstruation and pregnancy. Results The hysterectomy rate was 26.42% in hysterectomy group and 6.12% in hysteroscopy group (P <0.01). The improvement of menstruation in both groups was 81.13% and 95.92% (P <0.05). The pregnancy rate was 33.96% in the balloon group and 38.78% in the hysteroscopy group. The difference was not statistically significant (P> 0.05). Conclusions Severe uterine adhesions using 7 ~ 8mm hysteroscopy after regular monitoring can be effective in preventing reunion, improve menstrual improvement rate, but failed to significantly improve the pregnancy rate.