摘要目的 探讨宫腔球囊支架预防中重度宫腔粘连患者宫腔镜下宫腔粘连分离术后再粘连的效果.方法 选择2017年8月至2018年7月于广东医科大学附属厚街医院接受治疗的52例中重度宫腔粘连患者为研究对象,按随机数字表法分为对照组和实验组,每组26例.对照组于宫腔镜下宫腔粘连分离术后单独使用圆形节育环;实验组于宫腔镜下宫腔粘连分离术后放置宫腔球囊支架,7 d后取出支架再放置圆形节育环.两组均在第1次月经周期月经干净后3 d取出宫内节育环.观察两组术后48 h出血量、宫腔恢复情况、月经量及持续时间、再粘连发生率及并发症发生率.结果 实验组宫腔粘连复发率(0)、术后并发症发生率(3.85％)均低于对照组(23.08％、30.77％),差异有统计学意义(P<0.05);实验组术后48 h出血量[(46.28±3.54)ml]、术后月经量[(26.21±1.06)ml]及月经持续时间[(6.58±0.56)d]均优于对照组[(79.25±5.64)ml、(20.31±1.56)ml、(4.02±1.36)d],差异有统计学意义((P<0.05).结论 对中重度宫腔粘连患者,宫腔镜下宫腔粘连分离术后采用宫腔球囊支架治疗,可降低患者术后宫腔粘连的复发率,且术后48 h出血量较少,安全性高,值得临床推广应用.

abstractsObjective To investigate the effects of balloon-expandable stent on prevention against readhesion in patients with moderate-severe intrauterine adhesion after trans-cervical resection of adhesion. Methods Fifty-two patients with moderate-severe intrauterine adhesion who were treated in Houjie Hospital of Dongguan Affiliated to Guangdong Medical University from August 2017 to July 2018 were selected as research objects. And they were divided into control group and experimental group according to random number table method, with 26 cases in each group. Patients in control group were only implanted with loop after trans-cervical resection of adhesion. For patients after trans-cervical resection of adhesion in experimental group, balloon-expandable stent was implanted in cervix for 7 days firstly, and then the round loop was placed in their body after pulling stent out. The loops were took out at the third day after menstruation. The blood volume 48 hours after treatment, recovery of cavitas uteri, volume and duration of menstruation, readhesion rate and incidence of complications were observed and analyzed in the two groups. Results Readhesion rate and incidence of complications in experimental group(0,3. 85％) were significantly lower than those in contrl group (23. 08％,30. 77％), P<0. 05. The blood volume 48 hours after treatment, volume and duration of menstruation of experimental group was (46. 28 ± 3. 54) ml, (26. 21 ± 1. 06) ml and (6. 58 ± 0. 56) d, which were better than (79. 25 ± 5. 64)ml,(20. 31 ± 1. 56)ml and (4. 02 ± 1. 36)d of control group (P<0. 05). Conclusions For patients with moderate-severe intrauterine adhesion, implanting balloon-expandable stent after trans-cervical resection of adhesion could reduce readhesion rate with less blood volume 48 hours after operation and higher safety. It is worth clinical promotion and application.