解放军医学院学报2017，Vol.38Issue(10)：931-934,4.DOI:10.3969/j.issn.2095-5227.2017.10.007
宫腔镜下粘连分离术联合羊膜移植对复发性重度宫腔粘连的临床疗效
Clinical outcome of amnion graft following hysteroscopic adhesiolysis for treatment of recurrent severe intrauterine adhesion
摘要
Abstract
Objective To study the effect of amnion graft following hysteroscopic adhesiolysis in prevention of recurrent severe intrauterine adhesions (IUA).Methods Sixty cases with recurrent severe intrauterine adhesions were enrolled from December 2016 to June 2017 and randomly divided into two groups:experimental group (n=30) underwent hysteroscopic adhesiolysis followed by insertion of an amniotic membrane covered balloon of Foley's catheter,and control group (n=30) underwent hysteroscopic adhesiolysis followed by insertion of a balloon of Foley's catheter only.All patients received an artificial cycle (oral estradiol valerate 6 mg/d for 60 days,plus progestin 200 mg/d for the last 10 days) after trans-cervical resection of adhesion (TCRA).Hysteroscopy was performed one month later to remove the balloon and residual amniotic membrane,and the repair of endometrium was assessed.Patients who were cured or whose condition was greatly improved received three-dimensional transvaginal ultrasound examination in the first natural cycle.Thickness of endometrial,uterine volume and blood flow index were examined and compared.Results Cure rate and improvement rate in the experimental group were significantly higher than those in the control group [40％ (12/30) vs 16.67％ (5/30),P=0.045;73.33％ (22/30) vs 46.67％ (14/30),P=-0.035].Average endometrium thickness,uterine volume and blood flow index improved significantly in experimental group than those in control group [(8.36 ± 0.77) mm vs (7.21 ± 0.39) mm,P=0.002;(4.37 ± 0.37) cm3 vs (3.90 ± 0.26) cm3,P=0.029;(27.73 ± 0.48) vs (24.30 ± 0.46),P=0.001].The improvement rate of menstruation in experimental group was higher than that in control group [83.33％ (25/30) vs 60.00％ (18/30),P=0.045)].Conclusion Insertion of balloon of Foley's catheter with grafting of amnion is a promising adjunctive procedure for decreasing recurrence of adhesions for patients with severe IUA.关键词
宫腔粘连/羊膜移植/子宫内膜Key words
intrauterine adhesions/amniotic membrane transplantation/endometrium分类
医药卫生引用本文复制引用
周丽,刘国栋,龚月宾,闫文杰,李维,肖卓妮,袁静萍,曾智,杨菁..宫腔镜下粘连分离术联合羊膜移植对复发性重度宫腔粘连的临床疗效[J].解放军医学院学报,2017,38(10):931-934,4.基金项目
中央高校基本科研青年教师资助项目(2042017kf0073)Supported by the Basic Scientific Young Teacher of Central College (2042017kf0073) （2042017kf0073）
