Clinical Study Of Dydrogesterone Combined With Antibiotics In The Treatment Of Chronic Endometritis

Objective:By observing the changes in the expression of CD 138 in the endometrium of chronic endometritis(CE)patients treated with dydrogesterone combined with antibiotics,we explore the treatment options for CE,the consistency of hysteroscopy diagnosis and CE138 diagnosis of endometrium.Method:A total of 240 patients who were diagnosed as CE with positive CD 138 immunohistochemical staining at the Affiliated Hospital of North Sichuan Medical College from March 2018 to November 2019 were selected,and they understood and approved this clinical study.All patients underwent hysteroscopy,and the endometrium was taken for CD138 immunohistochemistry.The coincidence rate of hysteroscopy diagnosis and CD 138 immunohistochemical staining was compared.The patients were randomly divided into the observation group and the control group.There was no significant difference in general information between the two groups of patients(P>0.05),and they were comparable.The control group received oral antibiotics(levofloxacin+ornidazole)for two weeks.In the observation group,drogesterone was added on the basis of antibiotic treatment,and drogesterone was added on the 15th day of the menstrual cycle for 10 consecutive days.After the treatment(after the next menstruation),hysteroscopy was performed again and endometrial tissue was taken for CD 138 immunohistochemical staining.The negative rate of CD 138 in the two groups was compared.Statistical analysis was performed using SPSS 22.0 software.Result:1.The efficiency of the observation group was 77.19%and that of the control group was 69.83%,the difference was not statistically significant.(P>0.05).2.The efficiency of EPs patients in the observation group was 85.29%and non-EPs patients 65.22%,the difference was statistically significant(P<0.05).3.The efficiency of EPs patients in the control group was 70.15%and 69.39%for non-EPs patients,the difference was not statistically significant(P>0.05).4.The efficiency of EPs patients in the observation group was 85.29%and the efficiency of EPs patients in.the control group was 70.15%,the difference was statistically significant(P<0.05).5.The efficiency of non-EPs patients in the observation group was 65.22%and 69.39%in the control group,with no statistical significance(P>0.05).6.Of the 240 patients diagnosed with CE by positive CD 138 immunohistochemical staining,173(72.08%)were diagnosed with CE by hysteroscopy.Conclusion:1.The effectiveness of dydrogesterone combined with antibiotics in treating CE was 77.19%in the observation group and 69.38%in the control group,with no statistical significance.2.In patients with combined EPs with CE,the efficacy of dydrogesterone combined with antibiotics was significantly better than that of antibiotics alone,and in patients without combined EPs,the addition of dydrogesterone did not improve the efficacy of CE.3.Hysteroscopy can look directly at the lesion site of the uterine cavity and take the material at a fixed point to improve the diagnosis rate and reduce the harm caused by blind scraping to the patient,and in the process of clinical diagnosis of CE,it can be combined with CD138 immunohistochemistry diagnosis to reduce the rate of missed CE diagnosis.