| 舒丹,毛世华,吴燕,等.生长激素联合宫腔用交联透明质酸钠凝胶用于宫腔粘连分离术后辅助治疗的临床疗效观察[J].安徽医药,2024,28(5):1013-1016. |
| 生长激素联合宫腔用交联透明质酸钠凝胶用于宫腔粘连分离术后辅助治疗的临床疗效观察 |
| Clinical study of growth hormone combined with cross-linked sodium hyaluronate gel for adjuvant treatment of intrauterine adhesions after separation |
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| DOI：10.3969/j.issn.1009-6469.2024.05.035 |
| 中文关键词: 生长激素 宫腔用交联透明质酸钠凝胶 宫腔粘连 宫腔镜 |
| 英文关键词: Growth hormone Cross-linked sodium hyaluronate gel Intrauterine adhesions Hysteroscope |
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| 中文摘要: |
| 目的探讨生长激素联合宫腔用交联透明质酸钠凝胶用于宫腔粘连分离术(TCRA)后辅助治疗的临床疗效。方法选取 2020年 7月至 2021年 12月在重庆大学附属三峡医院诊断为中重度宫腔粘连的病人 60例，采用随机数字表法分为观察组和对照组，每组 30例，两组均实施宫腔镜下 TCRA，术后均予以雌孕激素序贯治疗。对照组手术结束后宫腔内灌注交联透明质酸钠凝胶；观察组在对照组基础上术后采用生长激素皮下注射；所有病人随访月经恢复情况及妊娠情况，在术后 1个月、 3个月行宫腔镜检查了解宫腔情况及再粘连情况，术后 3个月(月经周期第 10~15天)行超声检查了解子宫内膜厚度、子宫动脉搏动指数(PI)、子宫动脉血流阻力指数( RI)。结果术后 1个月，观察组轻度粘连 2例、中度粘连 1例，对照组轻度粘连 7例、中度粘连 3例；术后 3个月，观察组轻度粘连 4例、中度粘连 2例，对照组轻度粘连 10例、中度粘连 4例，观察组的再粘连率显著低于对照组( P<0.05)。术后观察组的子宫内膜厚度( 7.47±1.08)mm也较对照组( 6.83±1.21)mm明显增厚( P<0.05)观察组的 RI、PI也明显低于对照组，首次妊娠时间也明显短于对照组，均差异有统计学意义( P<0.05)。两组病人在治疗后的妊，娠率及月经恢复情况差异无统计学意义( P>0.05)。结论生长激素联合宫腔用交联透明质酸钠凝胶，作为宫腔粘连术后的辅助治疗，能有效促进子宫内膜修复、减少再粘连，值得临床推广。 |
| 英文摘要: |
| Objective To investigate the effect of growth hormone combined with cross-linked sodium hyaluronate gel for the adju-vant treatment after transcervical resection of uterine adhesions (TCRA).Methods A total of 60 patients diagnosed with moderate tosevere uterine adhesions in the Three Gorges Hospital Affiliated to Chongqing University from July 2020 to December 2021 were select-ed as the research subjects, and they were randomly assigned into observation group and control group,with 30 cases in each group.Bothgroups underwent hysteroscopic electrodesiccation of uterine adhesions (TCRA), and both groups were treated with sequential estrogenand progestin therapy after surgery. In the control group, intrauterine cavity was infused with cross-linked sodium hyaluronate gel afterthe operation; in the observation group, growth hormone was injected subcutaneously after the operation on the basis of the controlgroup. All patients were followed up for menstrual recovery and pregnancy, hysteroscopy was performed at 1 months, 3 months after sur-gery to understand the uterine cavity and re-adhesion, and ultrasonography was performed at 3 months after surgery (day 10-15 of men-strual cycle) to understand endometrial thickness, pulsed index (PI) and resistance index (RI) of uterine artery flow. Results At 1 month after surgery, there were 2 cases of mild adhesions and 1 case of moderate adhesions in the observation group and 7 cases of mildadhesions and 3 cases of moderate adhesions in the control group; at 3 months after surgery, there were 4 cases of mild adhesions and 2cases of moderate adhesions in the observation group and 10 cases of mild adhesions and 4 cases of moderate adhesions in the controlgroup, and the re-adhesion rate in the observation group was significantly lower than that in the control group (P<0.05). The endometri-al thickness of the observation group (7.47±1.08) mm was also significantly thicker than that of the control group (6.83±1.21) mm (P< 0.05), and the RI and PI of the observation group were also significantly lower than those of the control group, and the time to first preg-nancy was also significantly shorter than that of the control group, with statistically significant differences (P<0.05). There was no statis-tical difference between the two groups in terms of pregnancy rate and menstrual recovery after treatment (P>0.05). Conclusion Growth hormone combined with cross-linked sodium hyaluronate gel, as an adjuvant therapy after uterine adhesion separation, can ef-fectively promote endometrial repair and reduce re-adhesion, which is worthy of clinical promotion. |
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