Clinical effect of 2 kinds of barriers for intrauterine adhesion by hysteroscopic surgery

Yanming HUANG; Xin DU; Yan WANG; Yan YANG; Jing JIN; Dongmei YAO; Yulan LIU; Yin SHU

doi:10.16016/j.1000-5404.201702012

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Clinical effect of 2 kinds of barriers for intrauterine adhesion by hysteroscopic surgery

Clinical Medicine | 更新时间：2026-01-09

- Clinical effect of 2 kinds of barriers for intrauterine adhesion by hysteroscopic surgery
- Journal of Third Military Medical University Vol. 39, Issue 13, Pages: 1396-1399(2017)
- 作者机构：
  
  430070 武汉，湖北省妇幼保健院妇科
- 作者简介：
- 基金信息：
  
  the Instruction Program of Natural Science Foundation of Hubei Provincial Department of Science and Technology(2011CDC070)
- DOI：10.16016/j.1000-5404.201702012
  CLC： R197.39;R711.74;R713.4
- Received：04 February 2017，
  
  Revised：2017-03-19，
  
  Published：15 July 2017
- 稿件说明：
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Yanming HUANG, Xin DU, Yan WANG, et al. Clinical effect of 2 kinds of barriers for intrauterine adhesion by hysteroscopic surgery[J]. Journal of Third Military Medical University, 2017, 39(13): 1396-1399.
DOI：

Yanming HUANG, Xin DU, Yan WANG, et al. Clinical effect of 2 kinds of barriers for intrauterine adhesion by hysteroscopic surgery[J]. Journal of Third Military Medical University, 2017, 39(13): 1396-1399. DOI： 10.16016/j.1000-5404.201702012.

摘要

目的

探讨两种宫腔屏障用于中重度宫腔粘连(intrauterine adhesion，IUA)行宫腔镜下宫腔粘连分离术(transcervical resection of adhesions，TCRA)后的临床效果。

方法

选取2016年1月至2016年6月湖北省妇幼保健院收治的中重度宫腔粘连患者52例，按术后构建宫腔屏障方法的不同按随机数字表法分为两组。观察组：术毕宫腔放置Foley球囊+自交联透明质酸钠凝胶，术后1 d取出球囊，1周后宫腔镜探查并再次注入自交联凝胶；对照组：术毕放置Foley球囊+普通医用透明质酸钠凝胶，术后1周取出球囊，宫腔镜探查，置入宫内节育器及普通透明质酸钠凝胶。所有患者均行人工周期治疗。观察术后3月各组宫腔粘连AFS评分及治疗有效率、宫腔再粘连率。

结果

两组患者术后3个月时AFS总分和粘连范围、粘连类型、月经状况单项评分均较术前明显下降，差异均有统计学意义(

＜0.05)。两组间比较，观察组AFS总分、月经状况评分、再粘连率均低于对照组，治疗有效率高于对照组，差异均有统计学意义(

＜0.05)。

结论

TCRA术后应用Foley球囊+自交联透明质酸钠凝胶作为宫腔屏障，是提高IUA疗效的有效方法。

Abstract

Objective

To investigate the clinical effect of 2 kinds of intrauterine barriers for the patients with moderate to severe intrauterine adhesion (IUA) after hysteroscopic transcervical resection of adhesions (TCRA).

Methods

A total of 52 patients with moderate to severe IUA undergoing TCRA via hysteroscopy in our hospital from January 2016 to June 2016 were enrolled in the study. They were randomly divided into 2 groups according to various intrauterine barriers. In the observation group

Foley balloon catheter and crosslinked sodium hyaluronate gel were introduced into uterine after operation

and then the catheter was pulled out on the next day. Second-look hysteroscopic examination was performed ataweek later and auto-crosslinked sodium hyaluronate gel was given to uterine again at the same time. In the control group

the Foley balloon catheter and common medical sodium hyaluronate gel were introduced into the uterine after operation. Second-look hysteroscopy was also performed and the catheter was also pulled out ataweek later

meanwhile

an intrauterine device was given to uterine. Artificial cycle treatment and monthly second-look hysteroscopy was performed for all patients. At 3 months postoperatively

all cases were assessed for the shape of uterus cavity and menstruation

the severity of IUA by American Fertility Society (AFS) classification

treatment efficacy and recurrence of IUA.

Results

The total AFS score

scores of adhesive range and type

and menstrual pattern in 3 months were significantly lower than before operation in both groups (

0.05). The total AFS score

menstrual pattern and rate of re-adhesion were significantly lower in the observation group than the control group

and the effective rate was significantly higher (

0.05).

Conclusion

Foley balloon catheter and auto-crosslinked sodium hyaluronate gel as intrauterine barrier after TCRA is an optional approach for IUA treatment.

关键词

Keywords

references

夏恩兰.宫腔镜学及图谱[M]. 2版, 郑州:河南科学技术出版社, 2009:279-297.

XIA E L. An atlas of hysteroscopy[M]. 2nd Ed, Zhenzhou: Henan Science and Technology Press, 2009:279-297.

YU D, WONG Y M, Cheong Y, et al . Asherman syndrome-one century later[J ] . Fertil Steril, 2008, 89(4):759-779. DOI: 10.1016/j.fertnstert.2008.02.096

HEALY M W, SCHEXNAYDER B, CONNELL M T, et al . Intrauterine adhesion prevention after hysteroscopy: a systematic review and meta-analysis[J ] .Am J Obstet Gynecol, 2016, 215(3):267-275.e7. DOI: 10.1016/j.ajog.2016.05.001

MYERS E M, HURST B S. Comprehensive management of severe Asherman syndrome and amenorrhea[J]. Fertil Steril, 2012, 97(1):160-164. DOI: 10.1016/j.fertnstert.2011.10.036

TSUI K H, LIN L T, CHENG J T, et al . Comprehensive treatment for infertile women with severe Asherman syndrome[J ] . Taiwan J Obstet Gynecol, 2014, 53(3):372-375. DOI: 10.1016/j.tjog.2014.04.022

LISTED N. The American fertility society classifications of adnexal adhesions, distal tubal occlusion, tubal occlusion secondary to tubal ligation, tubal pregnancies, mullerian anomalies and intrauterine adhesions[J]. Fertil Steril, 1988, 49(6):944-955.

肖松舒, 万亚军, 邹放军, 等.自交联透明质酸钠凝胶预防中重度宫腔粘连分离手术后再粘连的前瞻性、随机、阴性对照临床研究[J].中华妇产科杂志, 2015, 50(1):32-36. DOI:10.3760/cma.j.issn.0529-567x.2015.01.008

XIAO S S, WAN Y J, ZOU F J, et al . Prevention of intrauterine adhesion with auto-crosslinked hyaluronic acid gel:a prospective, randomized, controlled clinical study[J ] . Chin J Obstet Gynecol, 2015, 50(1):32-36. DOI:10.3760/cma.j.issn.0529-567x.2015.01.008

黄燕明, 王燕, 郎雁, 等.宫腔粘连综合治疗218例预后分析[J].中国实用妇科与产科杂志, 2015, 31(11):1025-1028. DOI:10.7504/fk2015100112

HUANG Y M, WANG Y, LANG Y, et al . Analysis of prognosis after comprehensive treatment for 218 cases of intrauterine adhesion[J ] . Chin J Prac Gynecol Obstet, 2015, 31(11):1025-1028. DOI:10.7504/fk2015100112

黄燕明, 王燕, 郎雁, 等.综合治疗中重度宫腔粘连的疗效观察[J].中国妇产科临床杂志, 2015, 16(2):160-162. DOI:10.13390/j.issn.1672-1861.2015.02.020

HUANG Y M, WANG Y, LANG Y, et al . Clinical effect observation of comprehensive treatment for moderate or serious intrauterine adhesion[J ] . Chin J Clin Obstet Gynecol, 2015, 16(2):160-162. DOI:10.13390/j.issn.1672-1861.2015.02.020

DI SPIEZIO SARDO A, SPINELLI M, BRAMANTE S, et al . Efficacy of a polyethylene oxide-sodium carboxymethyl cellulose gel in prevention of intrauterine adhesions after hysteroscopic surgery[J ] . J Minim Invasive Gyneco1, 2011, 18(4):462-469. DOI: 10.1016/j.jmig.2011.04.007

CHEN Q, SUN G, WANGg Y, et al . The evaluation of two new hyaluronan hy drogels as nasal dressing in the rabbit maxillary sinus[J ] . Am J Rhinol Allergy, 2012, 26(2):152-156. DOI: 10.2500/ajra.2012.26.3715

AAGL Advancing Minimally Invasive Gynecology Worldwide. AAGL Practice Report: Practice Guidelines for Management of Intrauterine Synechiae[J]. J Minim Invasive Gynecol, 2010, 17(1):1-7. DOI: 10.1016/j.jmig.2009.10.009

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