A Clinical Research About The Effectiveness,safety And Patient Acceptance Of Different Methods In The Treatment Of Moderate To Severe Intrauterine Adhesions

Objective: To investigate the effectiveness,safety and patient acceptance of different methods in preventing the recurrence of adhesions after separation of moderate to severe intrauterine adhesions to guide the clinical treatment of intrauterine adhesions in the future.Methods: A total of 157 patients with moderate to severe intrauterine adhesions were enrolled into this study in the gynecological ward of Shengjing Hospital affiliated to China Medical University.All patients underwent transcervical resection of adhesion by hysteroscopy with intrauterine balloon stent(experimental group 1),Foley balloon catheter(experimental group 1),intrauterine device(experimental group 1)or nothing(control group).All patients were treated with prophylactic antibiotics and artificial cycle treatment after operation.Hysteroscopy was reviewed 1-3 months after the operation.The postoperative treatment effects and the improvement of menstrations in the 3 groups were compared,and find out the patient acceptance to different devices.Results: The intrauterine adhesion scores of the 4 groups of patients were significantly reduced after treatment(P<0.05),compared with the control group,the postoperative adhesion scores of the 3 experimental groups decreased more,and the difference was statistically significant(P<0.05).Compared with experimental group 2and experimental group 3,experimental group 1 had a more significant decrease in adhesion score,and the difference was statistically significant(P<0.05);but the experimental group 2 and the experimental group 3 had no significant difference in the degree of decrease of adhesion score(P=1.000).The menstrual improvement rates of the 4 groups were 88.2%,68.0%,72.0%,and 60.0%,respectively,and the difference was not statistically significant(P>0.05).The white blood cell count of the4 groups was significantly higher than those before the operation,and the difference was statistically significant(P<0.05).The rates of abnormal postoperative white blood cell count increase in the 4 groups were 5.9%,22.2%,12.0% and 22.5% respectively,and the difference was not statistically significant(P>0.05).All patients had no complications such as intraoperative and postoperative uterine perforation,fever,hemorrhage,severe abdominal pain.All patients who use the intrauterine balloon stent have higher acceptance to it.Conclusion: The intrauterine balloon stent,Foley catheter and intrauterine device can improve moderate to severe intrauterine adhesions.Among them,the intrauterine balloon stent is significantly better than Foley catheter and intrauterine device.The Foley catheter and intrauterine device have no significant difference in the improvement of moderate to severe intrauterine adhesions.The intrauterine balloon stent,Foley catheter and intrauterine device have similar performance in improving the menstruation condition of moderate to severe intrauterine adhesions.The intrauterine balloon stent,Foley catheter and intrauterine device all have good safety,and will not bring extra burden to patients.The intrauterine balloon stent has good efficacy,safety and patient acceptance in the treatment of moderate to severe intrauterine adhesions,and the effect of improving moderate to severe intrauterine adhesions is significantly better than Foley balloon catheter and intrauterine device,so it is more worthy of clinical use.