| ObjectiveTo investigate the effects of Foley balloon combined with artificial cycle on endometrium,uterine artery repair,menstrual improvement rate and postoperative pregnancy rate in patients with intrauterine adhesion(IUA),and to analyze the safety of the combined treatment scheme,so as to provide a theoretical basis for clinical prevention of re adhesion after TCRA.MethodsSelect 112 women who visited our department of gynecology from January2021 to March 2022,all of whom were moderate and severe IUA patients undergoing TCRA.Randomly divided into control group(n = 61 cases)and observation group(n = 61 cases).The control group was put into the IUD ring(medium size,provided by Yantai family planning Pharmaceutical Machinery Co.,Ltd.,placed in the uterus for more than 3 months),while the observation group was put into the uterine cavity with a Foley balloon(provided by Changzhou bairuiji biomedical Co.,Ltd.,national machinery approval: 20153641542).During the placement process,3 ~ 5 ml normal saline should be injected in combination with the size of the patient’s uterine cavity,It was removed 3-5 days after operation.All patients were routinely treated with anti-inflammatory drugs and anti infection after operation.They were treated with artificial cycle for 3 months,supplemented by6 mg estradiol + 200 mg progesterone capsule.They were rechecked regularly.Hysteroscopy was performed after 3 months,and the menstrual volume and cycle were observed and recorded.The endometrium,uterine artery repair,menstrual improvement rate and postoperative pregnancy rate were compared between the two groups.All data collected were collected using spss23 0 statistical software for processing.The measurement data is expressed in(x ± s),the inter group data is expressed in independent sample t-test,the intra group data is expressed in pairedsample t-test,and the counting data is expressed in(%),χ 2 test,P < 0.05,the difference was statistically significant.Results:(1)There was no significant difference between the two groups in clinical general data(including age,body mass index,adhesion severity [according to IUA classification method of European Society of gynecological endoscopy(ESGE)),menstrual condition,preoperative endometrial thickness,duration of disease course,etc.)(P > 0.05).All patients underwent TCRA successfully.(2)Uterine cavity recovery(ESGE grade): in the observation group,54 cases(88.52%),5 cases(8.2%)of mild(grade I or II),2 cases(3.38%)of moderate(grade III)and 0 cases(0%)of severe(grade IV and above)returned to normal after treatment;The control group were 41 cases(67.21%),10 cases(16.39%),8 cases(13.33%)and 2 cases(3.38%),respectively.There was significant difference between the two groups(P < 0.05).(3)Menstrual recovery: the number of effective(return to normal + basic improvement)and ineffective cases of postoperative menstrual recovery in the observation group was significantly better than that in the control group,and the difference between the groups was statistically significant(P < 0.05).(4)Endometrial thickness: the endometrial thickness in the observation group after treatment was(7.16 ± 0.89)mm,which was significantly higher than that in the control group(5.22 ± 0.91)mm.The difference between the groups was statistically significant(P<0.05).(5)Three months after treatment,the endometrial blood flow and lower blood flow parameters in the observation group after Foley balloon combined with artificial cycle treatment were significantly improved compared with those in the control group(P<0.05).Conclusion Foley balloon therapy combined with artificial cycle after operation can significantly improve endometrial blood flow,promote endometrial repair,improve uterine cavity morphology and prevent re adhesion after TCRA,which is worthy of further study. |
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