Analysis Of Intrauterine Adhesions Clinical Characteristics And Treatment

Objective:Retrospective analysis of the clinical data of patients with intrauterine adhesions in our hospital,To understand the age distribution,symptoms,reproductive history,history of uterine cavity operation,gynecological ultrasound findings,hysteroscopy results,the type of intrauterine adhesions,the degree of intrauterine adhesions,follow-up treatment and reexamination of the results of hysteroscopy results about patients with intrauterine adhesions.Analysis of clinical features of intrauterine adhesions,to evaluate the effect of the treatment of Hysteroscopic operation and postoperative recurrence.Methods:All the 155 patients were suspected or diagnosed intrauterine adhesions in hysteroscopic surgery from 2014 to January 2017 in No.1 Hospital of Jilin University Reproductive gynecology.and carry out a retrospective analysis and grouping with control for comparision to analyze the clinical data.Statistical analysis was performed by one-way ANOVA,SNK test,Mann-Whitney or Kruskal-Wallis test,chi square test or Fisher 's exact probability test.Results:1.The occurrence of different degrees of intrauterine adhesions,.the age group under 35 years old was significantly higher than the age group above the age of 35.2.The main reasons of the patients were menstruation reduction,infertility and recurrent abortion,a total of 150 cases,accounted for 96.77%.The conventional color Doppler ultrasound examination showed abnormal echo in uterine cavity,80% patients with mild ntrauterine adhesions,and more than 20% patients with moderate ntrauterine adhesions,No severe intrauterine adhesions.The most important manifestation of mild intrauterine adhesions is the abnormal menstruation,Most of the patients with moderate intrauterine adhesions were recurrent spontaneous abortion,and the most severe intrauterine adhesions are recurrent abortion.3.In the 155 cases,the average number of abortion was 1.94±0.13,the abortion times up from 0 to 9,the degree of intrauterine adhesions was associated with the number of abortions,it is suggested that the relationship between mild intrauterine adhesions and moderate intrauterine adhesions,the more the number of abortions,the greater the degree of intrauterine adhesions.4.Artificial abortion,missed abortion and drug abortion,spontaneous abortion and curettage after induction,hysteroscopic resection of endometrial polyps,submucous myoma of uterus excision,excision of cervical polyp,uterine septum resection,hysteroscopy,hysteroscopic intrauterine adhesions are risk factors of intrauterine adhesions.5.Intrauterine adhesions in the transvaginal color Doppler ultrasound showed that the echo of the endometrium is not uniform,the endometrium of the uterus,the continuity of the interruption of the endometrium,uterine cavity separation,the palace angle is not clear,no abnormalities,etc.The mild adhesion gynecological sonography mainly no abnormal 15 cases,accounted for 40.5%,moderate intrauterine adhesions in gynecologic ultrasonography mainly interrupted 50 cases,accounted for 47.6%,severe intrauterine adhesions in gynecologic ultrasonography mainly discontinuity of 10 cases,accounting for 76.9%.6.The correlation between hysteroscopic intrauterine adhesions in different position and severity of intrauterine adhesions,cervix adhesion showed mild intrauterine adhesions,intrauterine adhesions with different positions are decreased,which is greater than the central palace angle is greater than the uterine wall than the uterus.7.The operation time of patients with mild intrauterine adhesions was 28.46 ±14.57,which was significantly higher than that of patients with severe intrauterine adhesions.8.The recurrence rate was 25.4% after hysteroscopy,and the recurrence rate was 50% after severe intrauterine adhesion.With the increase of adhesion degree,the recurrence rate of intrauterine adhesion increased gradually.9.Three methods for promoting the growth of endometrium and preventing recurrence of intrauterine adhesions,there was no statistical difference in the treatment of intrauterine adhesions.The first drug treatment of intrauterine adhesion effective percentage was 63.2%,the second drug treatment of intrauterine adhesion effective percentage was 58.1%,The first drug treatment of intrauterine adhesion effective percentage was 46.2%.Conclusions:1.The occurrence of different degrees of intrauterine adhesions,.the age group under 35 years old was significantly higher than the age group above the age of 35.2.History of uterine cavity operation related to pregnancy,hysteroscopy surgery is associated with degrees of intrauterine adhesions,missed abortion is a risk factor for severe intrauterine adhesions.3.The degree of intrauterine adhesions was related to the number of abortion,and the number of abortion of moderate intrauterine adhesions was significantly higher than that of mild intrauterine adhesions.4.The correlation between hysteroscopic intrauterine adhesions in different position and severity of intrauterine adhesions,cervix adhesion showed mild intrauterine adhesions,intrauterine adhesions with different positions are decreased,which is greater than the central palace angle is greater than the uterine wall than the uterus.5.Progynova,progynova combined with dydrogesterone,femonston can be used for preventing the recurrence of uterine cavity adhesion,individualized treatment should be performed according to different patients.