Retrospective Analysis Of 69 Cases With Severe Intrauterine Adhesion

Ojective: Through retrospectively analyse clinical data of 69 cases with severe intrauterine adhesion(IUA),Analyzed from the age、whether estrogen pretreatment、 course of Estrogen treatment 、 previous times of intrauterine operation, in order to evaluate related prognostic factors of severe IUA.Method: Collect data of 81 patients with severe intrauterine adhesion during September 2014 ~ August 2015 in first affiliated hospital of chongqing medical university,peruse Data of cases and Hysteroscopic surgery record,obtain related information. 69 patients received telephone follow-up,complete data was got and analyzed with statistical software spss19.0.Results: 21 of 69 patients received estrogen pretreatment 1-6months with dose 3mg/d-9mg/d. pretreatment group versus no pretreatment group,there are no significant difference in menstruation improvement rate 、repeated adhesion rate、pregnancy rate(p>0.05);According to different estrogen taking time, divide the patients into three groups:≤3 months group,4-6 months group,>6 months group, there are no significantdifference among those groups in menstruation improvement rate and pregnancy rate(p>0.05). correlation Between course of taking estrogen and recovery of Uterine cannot be compared because almost nobody reexamination of hysteroscopy after drug withdrawal;patients with previous intrauterine operation >3 times have a lower menstruation improvement rate and a higher repeated adhesion rate,versus ≤3 times group.as well as,≤3 times group Moderate to severe adhesion rate is 8.3%(3/36),>3 times group is 36.4%(8/22),the difference between two groups is statistically significant(P=0.022);age has no correlation with prognosis of severe IUA;Up to now,20 of 69 patients didn’t take out IUD yet(17patients satisfied with current menstrual quantity),38 patients menstruation improved and 11 patients menstruation have no improvement before IUD take out,18 of 38 patients Menstruation decreased after IUD take out,compare menstruation improvement rate before IUD take out with after,there are significant difference(p=0.000).Conclusion:Whether estrogen pretreatment 、age、Prolong estrogen use has no correlation with prognosis of severe IUA;Pregnancy-related intrauterine operation and intrauterine operation for many times are the main reasons of severe IUA.The more times of intrauterine operation the worse for menstruation improvement and Uterine cavity recovery;3.Transcervical resection of adhesion is a effective method for severe IUA,to reduce postoperative recurrence,effective 、long term 、regular follow up is necessary;all the results need Large sample, prospective, randomized controlled studies to Further analysis.