| Objective Intrauterine adhesions(IUAs),also known as Asherman’s syndr ome,have long been thought of as a rare phenomenon,However,w ith expanded clinical awareness and the improvement of the treatme nt of gynecological diseases,the incidence of IUA and the detectio n rate increased gradually.Tanscervical resection of uterine separation of adhesion(TCRA),is the preferred surgical treatment of intrauteri ne adhesions,but due to the high recurrence rate of the disease,pr evention of postoperative adhesion recurrence have become an impo rtant target for the treatment of intrauterine adhesions,but the clinica l measures for the prevention of adhesion recurrence hane no unifor m standard.This article compares the clinical effect of common pre vention measures for intrauterine adhesions after the separation of u terine cavity adhesion in Shengjing Hospital of China Medical Univ ersity,so as to find better preventive measures for recurrence of int rauterine adhesions.Method A retrospective analysis from January 1,2014 to January 1,2016 at the China Medical University hospital,diagnosed 150 cases o f moderate to severe intrauterine adhesions in patients with clinical data and with TCRA surgery.Patients were divided into two group s: Postoperative indwelling IUD(intrauterine device,IUD)for 2 m onths,while intrauterine injection of sodium hyaluronate gel for gro up A,the Foley balloon catheter after injection 3-4 m L normal sali ne to the balloon,and sodium hyaluronate gel for group B.through catheter injection,postoperative use of antibiotics to prevent infecti on,all of the patients were treated with artificial cycle therapy for 2 months,and compared with the recovery period of 2 months afte r operation,the therapeutic effect of two group method and pregnan cy rate.Result Moderate adhesion patients,A group and B group treatment effe ct comparison: χ2 =0.653 P =0.419,the difference was not statistica lly significant.Severe adhesion patients: A group and B group tream ent effect comparison: χ2 =4.597 P =0.032,the difference was statis tically significant.There was no significant difference in the rate of pregnancy between the two groups of patients with moderate and se vere adhesions.Logistic regression analysis showed that age(OR 1.889 95%CI(1.442-2.473)P=0.000),uterine cavity operation times to prevent recurrence(OR21.818 95%CI(4.717-100.910)P=0.000)and postoperative treatment effect(OR 8.192 95%CI(2.487-26.985)P=0.001),which is the postoperative recovery of menstruation and uterin e cavity recovery,are the independent risk factors that effects the r ate of pregnancy after the surgery of intrauterine adhesions.Conclusion 1.In patients with severe adhesion,intrauterine adhesion after sur gery,supplemented by artificial cycle and method of hyaluronic aci d and indwelling uterine balloon for prevention of adhesion recurren ce,can improve menstrual and uterine cavity shape recovery,the eff ect is better than that of indwelling IUD,and for patients with mo derate adhesion,the effects of two kinds of prevention methods are basically the same.2.In terms of pregnancy rate,there is no significant difference in the pregnancy rate between the indwelling uterine cavity balloon and the indwelling IUD 3.The age of patients,the number of operations in uterine cavit y and the effect of preventing recurrence after operation,that is,th e recovery of menstruation and the recovery of uterine cavity morp hology are independent risk factors for pregnancy after intrauterine adhesions.Therefore,for preventing the recurrence of intrauterine ad hesions,individualized treatment should be followed,and multiple measures to prevent adhesion should be combined to achieve the best therapeutic effect and reduce the recurrence rate.At the same ti me,we should follow up the long-term follow-up of the patients w ith intrauterine adhesions to guide the pregnancy and achieve the ul timate goal of restoring normal reproductive function... |
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