Effects of different estrogen administration regimens on recurrence of adhesion after hysteroscopic surgery in patients with moderate to severe intrauterine adhesions
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摘要:
目的 探讨2种不同雌激素用药方案对中重度宫腔粘连(IUA)患者术后粘连复发及子宫内膜生长的疗效。 方法 采用简单随机法将82例患者分为芬吗通组和补佳乐组,每组41例。观察2组月经恢复效果、子宫内膜形态恢复效果、子宫内膜厚度和血清雌二醇(E2)变化。治疗后随访6个月,比较2组宫腔粘连复发情况。 结果 治疗2个月后,芬吗通组月经恢复总有效率为95.12%, 高于补佳乐组的80.49%, 差异有统计学意义(P<0.05); 芬吗通组A型宫腔形态比率为78.05%, 高于补佳乐组的56.10%, 差异有统计学意义(P<0.05); 2组治疗后子宫内膜厚度和血清E2水平高于治疗前,差异有统计学意义(P<0.05); 芬吗通组治疗后子宫内膜厚度、血清E2水平高于补佳乐组,差异有统计学意义(P<0.05); 术后6个月,芬吗通组粘连复发率为7.32%, 低于补佳乐组的24.39%, 差异有统计学意义(P<0.05)。 结论 芬吗通能有效改善月经恢复情况和宫腔形态,促进子宫内膜生长,降低宫腔镜术后粘连复发率,临床效果优于补乐佳。
Abstract:Objective To explore the effects of two different estrogen regimens on the recurrence of postoperative adhesions and endometrial growth in patients with moderate to severe intrauterine adhesion(IUA). Methods A total of 82 patients were divided into femoston group and progynova group by simple random method, with 41 cases in each group. The effects of menstruation recovery, endometrial morphology recovery, endometrial thickness and serum estradiol(E2)changes in the two groups were observed. Follow up for 6 months after treatment, the recurrence of intrauterine adhesions was compared between the two groups. Results After 2 months of treatment, the total effective rate of menstrual recovery was 95.12% in the femoston group, which was significantly higher than 80.49% in the progynova group(P<0.05); the proportion of type A uterine cavity morphology in the femoston group was 78.05%, which was significantly higher than 56.10% in the progynova group(P<0.05); endometrial thickness and serum E2 level were significantly higher after treatment than treatment before(P<0.05); after treatment, endometrial thickness and serum E2 level in the femoston group were significantly higher than those in the progynova group(P<0.05); at 6 months after the operation, the recurrence rate of adhesions in the femoston group was 7.32%, which was significantly lower than 24.39% - in the progynova group(P<0.05). Conclusion Femoston can effectively improve the menstrual recovery and uterine cavity shape, promote endometrial growth, reduce the rate of adhesion and recurrence after hysteroscopy, and the clinical effect is better than that of progynova.
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