Clinical Application Study On Multimodality Therapy After The Transcervical Resection Of Urerrine Adhesion

Objective To evaluate the effect of multimodality therapy after the transcervical resection ofuterine adhesion, to study the clinical practice on the therapy,and to explore theappropriate Time forhysteroscopic inspection after the transcervical resection of uterine adhesion. We Expect themultimodality therapy will be extended. Methods The102patients was diagnosed by medicalhistory,clinical ferture, BModeul-trasound, uterine adhesion were divided into A、B、C、threegroups：group A (intrauterine device, IUD),group B(IUD+balloon urinary catheter),group C(IUD+balloonurinary catheter+hysteroscopy at regular intervals). The age of patients by one-way analysis of variancewas not statistically significant （p＞0.05）. All patients takeProgesterone tablets and progynova tablets regularly for three consecutive mouths.it could promote thegrowth of endometrium. Group A and group B was done hysteroscopic inspection at3monthsaftersurgery,group C was done the first hysteroscopic inspection at2weeks after surgery,then check atotal of four times at3-5days after menstruation for three consecutive months,wich to observe uterinecavity form and to separate new adhesion.All the patients were followed by the hysteroscopy andmenstrual recovery at three months after operation。Group C was followed by the hysteroscopy fourtimes.Results The results of hysteroscopy is that there have38cases of patients in group A,among them,23cases were cured,7cases were effective,7cases were invalid.The effective rate was78.9%in groupA.There have24cases of patients in group B, among them,17cases were cured,4cases were effective,1cases were invalid.The effective rate was95.8%in group B,there have40cases of patients in group C,among them,16cases were cured,3cases were effective,0cases were invalid.The effective rate was100%in group C.The situstion of improvement of menstruation is that in group A,17cases werereturned to normal,8cases were effective,13cases were invalid.The effective rate was65.8%.In groupB,16cases were returned to normal,5cases were effective,3cases were invalid.The effective rate was87.5%.In group B,36cases were returned to normal,3cases were effective,1cases were invalid.Theeffective rate was97.5%.Statistical analysis results are as follows.The recover of uterine cavity form ingroup C was superior to group A and B(P＜0.05), and the improvement of menstrual situation ingroup C was superior to others (P＜0.05). Comparing both B and C group(The differences of two groupsis the time for hysteroscopic inspection).The recover of uterine cavity form and the improvement ofmenstrual situation in group V was superior to group B (P＜0.05).The40cases in group C werechecked by hysteroscopy a total of four times.The fist time check was in the second weed after surgery.In the fist check,25cases were cured,10cases were effective,5cases were invalid.Theeffective rate was87.5%.In the second check,28cases were cured,10cases were effective,2cases wereinvalid.The effective rate was95.0%.In the third check,31cases were cured,8cases were effective,1cases were invalid.The effective rate was97.5%.In the fourth check,38cases were cured,2cases wereeffective,0cases were invalid.The effective rate was100%.The adhesion rate of the group C reducedwith the increase of inspections(P＜0.05).Conclusions1.The multimodality therapy composed by aballoon urinary catheter, Medical Chitosan,IUD, regular hysteroscopy, estrogen and progesterone after the transcervical resection of uterine adhesioncould recover the uterine cavity form, prevent the recurrence of adhesion and improve the menstrualsituation effectively.2.The hysteroscopic inspection early and periodically could recover the uterinecavity form,prevent the recurrence of adhesion and improve the menstrual situation effectively.