雌孕激素序贯给药对宫腔粘连患者临床转归的影响
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摘要
目的探讨雌孕激素序贯给药对宫腔粘连(IUA)患者临床转归的影响。方法选取2012年3月～2015年3月妇产科收治的IUA患者87例,根据治疗方法不同分为对照组和观察组,前者40例,实行宫腔镜宫腔粘连分解术(TCRA),后者47例,TCRA后继续进行雌孕激素序贯给药治疗3个月,两组治疗结束后随访6个月,比较治疗前后子宫内膜容积、临床疗效及子宫再粘连发生情况。结果治疗前观察组、对照组子宫内膜容积比较差异无统计学意义(P>0.05);治疗后两组患者的子宫内膜容积均较治疗前增大,并且观察组的子宫内膜容积大于对照组(P<0.001)。治疗后6个月,观察组的治疗效果优于对照组,比较差异有统计学意义(P<0.05)。随访6个月,观察组再粘连发生率为2.13%(1/47),对照组的再粘连发生率为25.00%(10/40),比较差异有统计学意义(χ~2=10.235,P<0.01)。结论 TCRA后继续进行雌孕激素序贯给药治疗,疗效优于单纯行TCRA者。
Objective To study the effect of sequential administration of estrogen and progesterone on the clinical outcomes of patients with intrauterine adhesion(IUA).Methods 87 patients with IUA who were admitted in the department of gynaecology of our hospital between March 2012 and March 2015 were selected and randomly divided into control group(40 cases) and observation group(47).The control group were treated with bytrans-cervical resection of adhesion(TCRA),and the observation group were continuously given estrogen and progesterone for 3 months after TCRA.After treatment,both groups were followed up for 6 months,and then endometrial volume before and after treatment,treatment effect and the occurrence of uterine re-adhesion were compared between the two groups.Results Before treatment,there was no statistically significant difference in endometrial volume between the control group and the observation group(P>0.05);after treatment,the endometrial volume in both groups was larger than that before treatment,and the endometrial volume in the observation group was larger than that in the control group(P<0.001).After 6 months of treatment,the treatment effect of the observation group was better than that of the control group,difference was statistically significant(P<0.05).After 6 months of follow-up visit,the incidence of re-adhesion of the observation group was 2.13%(1/47),and that of the control group was 25.00%(10/40),so difference was statistically significant(χ~2=10.235,P<0.01).Conclusion The effect of sequential administration of estrogen and progesterone after TCRA was better than that of TCRA alone.
Objective To study the effect of sequential administration of estrogen and progesterone on the clinical outcomes of patients with intrauterine adhesion(IUA).Methods 87 patients with IUA who were admitted in the department of gynaecology of our hospital between March 2012 and March 2015 were selected and randomly divided into control group(40 cases) and observation group(47).The control group were treated with bytrans-cervical resection of adhesion(TCRA),and the observation group were continuously given estrogen and progesterone for 3 months after TCRA.After treatment,both groups were followed up for 6 months,and then endometrial volume before and after treatment,treatment effect and the occurrence of uterine re-adhesion were compared between the two groups.Results Before treatment,there was no statistically significant difference in endometrial volume between the control group and the observation group(P>0.05);after treatment,the endometrial volume in both groups was larger than that before treatment,and the endometrial volume in the observation group was larger than that in the control group(P<0.001).After 6 months of treatment,the treatment effect of the observation group was better than that of the control group,difference was statistically significant(P<0.05).After 6 months of follow-up visit,the incidence of re-adhesion of the observation group was 2.13%(1/47),and that of the control group was 25.00%(10/40),so difference was statistically significant(χ~2=10.235,P<0.01).Conclusion The effect of sequential administration of estrogen and progesterone after TCRA was better than that of TCRA alone.
引文
[1] 吴琼蔚,谢晖亮,马成斌.宫腔粘连767例临床分析[J].实用妇产科杂志,2014,30(5):354-357.
[2] 乔琳,何援利.加用防粘连膜的综合方法治疗重度宫腔粘连的临床效果观察[J].实用妇产科杂志,2013,29(9):686-689.
[3] 周曼萍,何援利,乔琳,等.转化生长因子-β1及Smad2/3在宫腔粘连患者子宫内膜组织中的表达及意义[J].广东医学,2014,35(12):1844-1847.
[4] 任娟,宋恩学,王文艳,等.子宫腔粘连患者子宫内膜组织中ER、PR的表达及意义[J].临床与实验病理学杂志,2015,31(4):380-384.
[5] 孙鲲,李春伶,刘卫星.宫腔粘连患者子宫内膜容积及血流参数的变化[J].中国超声医学杂志,2013,29(6):543-546.
[6] 赖映华.人流术后应用雌孕激素序贯疗法预防宫腔粘连的价值[J].海峡医学,2015,27(3):107-108.
[7] 刘明星,黄俊花,黄赟博.雌孕激素序贯治疗对人工流产不全的临床研究[J].热带医学杂志,2015,15(6):790-806.
[8] 何英新,唐彩霞,刘珏,等.人工周期对宫腔粘连患者子宫内膜中MMP-9和 TGF-β1表达的影响[J].重庆医学,2014,43(2):167-169.
[2] 乔琳,何援利.加用防粘连膜的综合方法治疗重度宫腔粘连的临床效果观察[J].实用妇产科杂志,2013,29(9):686-689.
[3] 周曼萍,何援利,乔琳,等.转化生长因子-β1及Smad2/3在宫腔粘连患者子宫内膜组织中的表达及意义[J].广东医学,2014,35(12):1844-1847.
[4] 任娟,宋恩学,王文艳,等.子宫腔粘连患者子宫内膜组织中ER、PR的表达及意义[J].临床与实验病理学杂志,2015,31(4):380-384.
[5] 孙鲲,李春伶,刘卫星.宫腔粘连患者子宫内膜容积及血流参数的变化[J].中国超声医学杂志,2013,29(6):543-546.
[6] 赖映华.人流术后应用雌孕激素序贯疗法预防宫腔粘连的价值[J].海峡医学,2015,27(3):107-108.
[7] 刘明星,黄俊花,黄赟博.雌孕激素序贯治疗对人工流产不全的临床研究[J].热带医学杂志,2015,15(6):790-806.
[8] 何英新,唐彩霞,刘珏,等.人工周期对宫腔粘连患者子宫内膜中MMP-9和 TGF-β1表达的影响[J].重庆医学,2014,43(2):167-169.