自交联透明质酸钠凝胶在中重度宫腔粘连行宫腔镜手术后患者中的应用效果

Effect of auto-crosslinked hyaluronic acid gel on patients with moderate to severe intrauteriae adhesion after hysteroscopy surgery

摘要:

目的   探讨自交联透明质酸钠凝胶对中重度宫腔粘连（IUA）患者行宫腔镜术后再粘连的预防效果。方法  选取2013年6月-2014年12月该院收治的92例行宫腔镜手术的中重度IUA患者为研究对象，并随机分为观察组和对照组，两组各46例。对照组术后在宫腔内置入Foley球囊导尿管，观察组在此基础上加用自交联透明质酸钠凝胶，比较两组术后3个月的美国生育学会（AFS）制定的IUA评分、有效预防率以及中重度IUA的发生率。结果   观察组手术后的粘连累及范围评分、月经状况评分及总分均明显低于对照组，差异均有统计学意义（P <0.05）。观察组的有效预防率高于对照组，中重度IUA发生率明显低于对照组，差异均有统计学意义（P <0.05）。结论   自交联透明质酸钠凝胶能有效预防中重度IUA术后再粘连的发生，安全可靠，值得临床推广应用。

Abstract:

 Objective To investigate the prevention effect of auto-crosslinked hyaluronic acid gel on re-adhesion for patients with moderate to severe intrauteriae adhesion (IUA) after hysteroscopy surgery. Methods 92 patients with moderate to severe IUA underwent hysteroscopy surgery from June 2013 to December 2014 were enrolled for the study and randomly divided into observation group and control group, 46 cases in each group. Patients in control group were given Foley balloon catheter to intrauterine after operation. Based on it, patients in observation group were given auto-crosslinked hyaluronic acid gel. American fertility society (AFS) IUA score, effective prevention rate and incidence of moderate to severe IUA in 3 months after operation were compared between the two groups. Results The scores of adhesive type and menstrual pattern and total AFS score of observation group in 3 months were significantly lower than that in control group (P < 0.05). Effective prevention rate of observation group was significantly higher than that in control group, and the incidence of moderate to severe IUA was significantly lower than that in control group, the differences had statistical significance (P < 0.05). Conclusions Auto-crosslinked hyaluronic acid gel could effectively prevent the happening of re-adhesion in patients with moderate to severe IUA after hysteroscopy surgery. It is safe and reliable, worthy of clinical popularization and application.