Observation On The Effect Of Balloon Combined With Twice Chitosan On Preventing Recurrence Of Adhesion After Moderate And Severe Intrauterine Adhesion

Objective:To discuss the effect of twice chitosan injection in uterus for decreasing time of intrauterine balloon implantation after the moderate or severe adhesion’s operation.Method:Cases were collected according to certain standards,57 cases with moderate and severe intrauterine adhesion were collected according to AFS scores and divided into two groups,Group A: 32 cases(8 cases moderate,24 cases severe);Group B: 25 cases(moderate 5 cases,severe 20 cases).Group A method: Immediately after standard TCRA,a chitosan with a Foley catheter were place into the uterine cavity for 3 days.After 3days,Foley catheter was removed from the uterus,after vagina was sterilized strictly,a second chitosan was injected into the uterine cavity then.Group B method: Immediately after standard TCRA,a chitosan with a Foley catheter were place into the uterine cavity for 7 days.Two groups of patients were reexamined by Hysteroscopy two months after the operation with second AFS assessment.Result: Research completed successfully.There were no significant differences considering age,gestation,preoperative AFS scores and proportion of moderate and severe cases between two groups.After operation,AFS score 0 represents mainly recovery,1-4: mild re-adhesion,5-8: moderate re-adhesion.The prognosis is well with0-4 scores.Compared with group B,group A had better result in Postoperative AFS score system(χ2=4.43,P=0.036,P<0.05).considering D-value(preoperative AFS score-postoperative AFS score),8 points represent highly effective;between 4 points to 8points represent moderate effective;Less than 4 points represent low-effective.Compared with group B,group A response highly remarkable in high effective group.Conclusion:This method,which combine twice chitosan with shorter Foley balloon placement time,makes full use of the preventive effect of chitosan on uterine adhesion.It not only shortens patients’ hospital stays,but also relieve discomfort after operation.It not only alleviates patients’ psychological and social pressure,but also conforms better effect on prevention of postoperative re-adhesion.So,it is recommended to be widely used in clinical practice.