Clinical Observation Of Hysteroscopic Treatment On Intrauterine Adhesions

Objective: To analyze the characteristics of intrauterine adhesions for determining the detection percentage, visit reasons and etiology of IUA in our hospital (the Second Xiangya Hospital, Central South University) trough counting up all the cases by the hysteroscopy, evaluating the efficacy of hysteroscopic adhesiolysis in patients with different clinical manifestations and different degrees, guiding the operation manipulation of doctors and treatments of patients after hysteroscopy.Methods: Applied retrospective study, we collected demographic and medical history information on 588 women who had hysteroscopic adhesiolysis from 2006 through 2008 in the Department of Gynaecology of our hospital(including outpatient and inpatient ). We calculated the detection percentage, analyzed the visit reasons and etiologies, evaluated the efficacy of hysteroscopic adhesiolysis in patients with different clinical manifestations and different degrees through follow-up study, compared differences in efficacy of hysteroscopic adhesiolysis in patients with different clinical manifestations and different degrees.Results:1. There were 588 cases of intrauterine adhesions; the detection percentage was 6.38%; it showed a gradually upgrading trend in IUA detection percentage annually.2. The main visit reasons were abnormal menstruation and dysfunction of procreation, of which the former shared 79.5% and the later 12.6%.3. The main etiologies were artificial abortion and evacuation, of which the former shared 62.4% and the later 25.2%. 4. There wasn't a correlation between degrees and clinical manifestations of IUA.5. It showed the total effective rate was 57.7%; The effective rate in patients with periodic abdominal pain was 65.7%,in patients with abnormal menstruation was 60.3%, in patients with dysfunction of procreation was 37.0%.6. The effective rate in mild patients was 62.0%,in moderate patients was 54.0%,in severe patients was 50.3%;in patients with procreation request, the delivery rate in mild patients was 73.6%, in moderate patients was 38.5%, in severe patients was 31.0%.Conclusions:1. The trend of the detection cases and detection percentage of IUA is upgrading gradually.2. The clinical manifestations are abnormal menstruation and dysfunction of procreation.3. IUA is mainly caused by artificial abortion and evacuation, both of which cause the defluvium and injury of the basal layer of endometrium.4. There isn't a correlation between degrees and clinical manifestations of IUA.5. The effective rate in patients with periodic abdominal pain is the highest; the effective rate in patients with abnormal menstruation is secondary highest; the effective rate in patients with dysfunction of procreation is lowest.6. The lower the degree of the IUA is, the higher the treatment efficacy is.