[1]葛春晓,裴德恩①,左怀之②.宫腔镜手术为主综合治疗重度宫腔粘连27例临床研究[J].中国微创外科杂志,2004,04(1):52-54.
　Ge Chunxiao*,Pei Deen,Zuo Huaizhi..Combination treatment with a predominance of hysteroscopic operations for severe intrauterine adhesion: Clinical study of 27 cases[J].Chinese Journal of Minimally Invasive Surgery,2004,04(1):52-54.
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宫腔镜手术为主综合治疗重度宫腔粘连27例临床研究()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
04
期数:
2004年1期
页码:
52-54
栏目:
出版日期:
2004-01-20

文章信息/Info

Title:
Combination treatment with a predominance of hysteroscopic operations for severe intrauterine adhesion: Clinical study of 27 cases
作者:
葛春晓; 裴德恩①; 左怀之②　
南京大学医学院附属鼓楼医院妇产科,南京,210008
Author(s):
Ge Chunxiao*;  Pei De’en;  Zuo Huaizhi.
Department of Obstetrics & Gynecology, Drum Tower Hospital of Medical College ofNanjing University, Nanjing210008, China
关键词:
宫腔粘连;  宫腔镜手术;  宫内节育器;  透明质酸钠
Keywords:
Intrauterine adhesion; 　Hysteroscopic operation; 　IUD; 　Sodium hyaluronate
分类号:
R713.4
文献标志码:
A
摘要:
目的探讨宫腔镜手术为主综合治疗重度宫腔粘连(intrauterine adhesion,IUA)的有效性和安全性. 方法 2000年4月～2003年3月,对27例经宫腔镜确诊的重度结缔组织性IUA施行宫腔镜IUA分离术. 结果 27例经宫腔镜手术分离58次,其中12例分离1次,7例分离2次,3例分离3次,2例分离4次,3例分离5次.术后随访8～46个月,平均27个月,月经恢复正常65.2%(15/23),仍闭经26.1%(6/23),月经仍少8.7%(2/23).宫腔形态恢复正常63.0%(17/27),基本正常33.3% (9/27),总有效率96.3%(26/27),术后宫腔再粘连3.7%(1/27).术后妊娠率57.1%(4/7),活产率42.9%(3/7).无手术并发症. 结论宫腔镜手术为主综合治疗重度IUA是安全、有效的方法.术后宫腔置放宫内节育器(IUD)与透明质酸钠可预防术后再粘连,雌孕激素周期治疗对子宫内膜修复有一定作用.
Abstract:
　Objective　To evaluate the effectiveness and safety of combination treatment with a predominance of hysteroscopic operations in the management of severe intrauterine adhesion (IUA).　Methods　Hysteroscopic exclusion was performed in 27 patients who were confirmed as severe fibrous IUA by hysteroscopy between April 2000 and March 2003.　Results　All the 27 patients underwent 58 times of hysteroscopic exclusion: once in 12 patients, twice in 7 patients, 3 times in 3 patients, 4 times in 2 patients and 5 times in 3 patients. Postoperative follow-up ranged 8~46 months (mean,27 months). Menstruation returned to nor- mal in 65.2% of the patients (15/23), amenorrhea continued in 26·1% of the patients (6/23), and hypomenorrhea remained in 8·7% of the patients (2/23). Shape of uterus cavity returned to normal in 63·0% of the patients (17/27) and to basically normal in 33·3% of the patients (9/27). The total effective rate of the study was 96·3% (26/27) while a re-adhesion took place in 3·7% of the patients (1/27). The pregnancy rate after operation was 57·1% (4/7) and the live delivery rate 42·9% (3/7). There were no operative complications in the study.　Conclusions　The combination treatment with a predominance of hysteroscopic operations in the management of severe IUA is safe and effective. IUD placement and sodium hyaluronate can prevent the postoperative re-adhesion. Periodic treatment of estrogen and progestogen has some actions for repairing endometrium.

参考文献/References:

［1］冯缵冲,邵敬於,主编.实用宫腔镜学.上海:上海医科大学出版社,1999.68-72.
［2］陆子兰,主编.有计划生育理论与实践.第1版.广州:广东科技出版社,1988.346.
［3］罗丽兰,主编.不孕与不育.北京:人民卫生出版社,1998.192-194.
［4］曹泽毅,主编.中华妇产科学.北京:人民卫生出版社,1999.2133-2134.
［5］Bukulmez O,Yarali H,Gurgan T.Total corporal synechiae due to tuberculosis carry a very poor prognosis following hysteroscopic synechialysis. Hum Reprod,1999,14:1960-1961.
［6］Frank WJ,Corla Bv,Karin VU,et al. Complications of Hysteroscopy: A prospective,multicenter study. Obstet Gynecol, 2000, 96: 267-270.
［7］张丹,夏恩兰,孟焱,等.宫腔粘连的介入性超声诊断和治疗.中国医学影响技术,2002,18:376-377.
［8］徐爱娣,陈敏,汪清,等.宫腔镜下Nd:YAG激光手术治疗宫腔粘连.中国激光医学杂志 , 2000,9:77-79.
［9］Rog P,Dercole C,Cravello L,et al. Hysteroscopic treatment of uterine synechias. A report of 102 casts. J Gynecol Obstet Biol Reprod (Paris),1996,25:33-40.
［10］Donnez J,Nisolle M. Hysteroscopic lysis of intrauterine adhesions (Asherman's syndrome). In:An atlas of laser operative laparoscopy and hysteroscopy. New York:The parthenon publishing Group lnc,1994.305-312.
［11］凌耘,于无笛,冯缵冲,等.B超监护下宫腔镜手术治疗宫腔粘连-附28例分析.上海医学,1998,21:492-493.

备注/Memo

备注/Memo:
①（南京市妇幼保键院 南京,210004）②（南京市计划生育指导所 南京,210016）　
更新日期/Last Update: 2014-05-14