国际妇产科学杂志

国际妇产科学杂志 ›› 2018, Vol. 45 ›› Issue (5): 593-595.

• 论著 • 上一篇    下一篇

宫形球囊和宫内节育器预防宫腔镜下子宫中隔切除术后宫腔粘连的比较

张博，叶红   

  1. 100006  北京，首都医科大学附属北京妇产医院妇科微创中心
  • 收稿日期:2018-04-27 修回日期:2018-07-03 出版日期:2018-10-15 发布日期:2018-10-18
  • 通讯作者: 叶红，E-mail：yehong8812@sina.com E-mail:yehong8812@163.com

Comparison of Uterine Cavity Shaped Ballon and Intrauterine Device in Preventing Intrauterine Adhesion after Hysteroscopic Uterine Septum Resection

ZHANG Bo, YE Hong   

  1. Department of Gynecology Minimal Invasive Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100006, China
  • Received:2018-04-27 Revised:2018-07-03 Published:2018-10-15 Online:2018-10-18
  • Contact: YE Hong, E-mail：yehong8812@sina.com E-mail:yehong8812@163.com

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摘要： 目的：探讨宫形球囊和宫内节育器（IUD）对预防宫腔镜下子宫中隔切除术（TCRS）术后宫腔粘连的临床效果。方法：收集2016年2月—2017年12月于首都医科大学附属北京妇产医院妇科微创中心行TCRS的65例患者的临床资料进行回顾性分析，A组（n=30）术后放置宫形球囊并给予人工周期治疗，B组（n=35）术后放置宫形IUD并给予人工周期治疗。术后3个月行宫腔镜检查，B组患者同时取出IUD。并记录患者月经情况、异常子宫出血情况、腰腹部不适情况。结果：2组均未发现宫腔粘连。术后3个月内A组患者未发生腰酸腹痛、异常子宫出血情况；B组患者发生IUD嵌顿2例（5.71%），发生腰酸腹痛6例（17.14%），子宫异常出血10例（28.57%），取出IUD后症状均缓解。2组腰酸腹痛和子宫异常出血情况差异均有统计学意义（P=0.027；P=0.001）。结论:宫形球囊和IUD预防TCRS术后宫腔粘连的效果基本相同，但宫形球囊放置时间短、不良反应少、取出方便而更具优势。

关键词: 子宫, 子宫疾病, 宫内避孕器, 宫腔镜, 黏连

Abstract: Objective：To explore the clinical effect of uterine cavity shaped ballon and intrauterine device (IUD) in preventing intrauterine adhesion (IUA) after hysteroscopic transcervical resection of uterine septum (TCRS). Methods: The clinical data of 65 patients with septate uterus were retrospectively analyzed. After surgery, 30 patients (group A) received uterine cavity shaped ballon and hormone replacement therapy, 35 patients (group B) received IUD and hormone replacement therapy. The hysteroscopic examination was performed after 3 months of surgery, the IUD was removed. The patients′ data were collected including menstruation, vaginal bleeding and lumbar or abdominal discomfort. Results: No IUA occurred in the two groups. During 3 months after surgery, in group A no lumbar or abdominal discomfort and abnormal uterine bleeding occurred，in group B 2 cases incarceration of IUD occurred with the incidence of 5.71%, 6 cases of lumbar or abdominal discomfort occurred with the incidence of 17.14% (P=0.027), 10 abnormal uterine bleeding occurred with the incidence of 28.57% (P=0.001), these symptoms relieved after removing IUD. Conclusions: No difference between the groups in preventing IUA after TCRS. Because of the side effects of IUD, uterine cavity shaped ballon is a more appropriate method.

Key words: Uterus, Uterine diseases, Intrauterine devices, Hysteroscopes, Adhesions