【摘要】 目的 探讨宫腔镜冷刀分离宫腔粘连术后的不同辅助治疗方案对宫腔粘连患者的临床疗效。方法 采用STORZ宫腔镜下冷刀宫腔粘连分离术(TCRA)对147例宫腔粘连患者进行治疗，按TCRA术后治疗方法不同分为对照组和观察组，对照组(78例)采用术后单纯雌孕激素治疗，观察组(69例)采用术后放置COOK球囊子宫支架联合雌孕激素治疗；观察组根据术后留置COOK球囊子宫支架的时间不同分为观察A组(小于1个月)、观察B组(1～3个月)。对比各组的术后月经、妊娠改善情况。结果 对照组和观察组术后妊娠情况比较，差异无统计学意义(P>0.05);观察组的术后月经量较对照组明显改善(P<0.001);观察B组术后妊娠率较观察A组高，组间比较差异有统计学意义(P<0.05),观察A组和观察B组的术后月经改善情况比较，差异无统计学意义(P>0.05)。结论 宫腔镜冷刀治疗宫腔粘连术后使用球囊子宫支架+雌孕激素能显著改善患者的月经量；留置球囊时间1～3个月比留置时间小于1个月更能提高患者术后妊娠率。更多还原

【Abstract】 Objective To explore the clinical efficacy of different adjuvant treatment plans for patients with uterine adhesions after hysteroscopic cold knife separation. Methods 147 patients with intrauterine adhesions were treated with STORZ hysteroscopic cold knife transcervical resection adhesion(TCRA). They were divided into control group and observation group according to different treatment methods after TCRA. The control group(78 cases) were given postoperative simple estrogen and progesterone therapy, while the observation group(69 cases) were given postoperative placement of COOK balloon uterine stents combined with estrogen and progesterone. The observation group were divided into observation group A(less than 1 month) and observation group B(1-3 months) based on the duration of postoperative COOK balloon uterine stent placement.And then, the improvement of postoperative menstruation and pregnancy in each group were compared.Results There was no statistically significant difference in postoperative pregnancy between the control group and the observation group(P>0.05). The postoperative menstrual volume in the observation group was significantly improved compared to that in the control group(P<0.001); the postoperative pregnancy rate in the observation group B was higher than that in the observation group A, and difference was statistically significant(P<0.05). However, there was no statistically significant difference in the postoperative menstrual improvement between the observation group A and the observation group B(P>0.05). Conclusion Balloon uterine stent + estrogen and progesterone in the treatment of intrauterine adhesions after hysteroscopy cold knife can significantly improve the menstrual volume of the patients. The indwelling balloon time of 1-3 months is more effective in improving the postoperative pregnancy rate of patients compared to indwelling balloon time less than 1 month.更多还原