Clinical Review Of 80 Cases Of Intrauterine Adhesions

Objective(s):Understanding the 80 cases of uterine adhesions admitted to our hospital etiology,auxiliary inspection results and clinical symptoms and other information,to evaluate the effectiveness of transcervical resection of adhesions in patients with intrauterine adhesions,after the placement of Foly urinary catheter and combined with estrogen or estrogen binds to progesterone after artificial cycle treatment of uterine cavity morphology recovery,menstrual improvement and pregnancy rate.Methods:A retrospective analysis of 80 patients with intrauterine adhesions in the outpatient and inpatient department of the First Affiliated Hospital of Kunming Medical University from June 2015 to December 2015,Patients were treated by transcervical resection of adhesions with micro-scissors,Placed water capsule hours to several days according to the degree of adhesion,mild to moderate patients oral estradiol valerate 2#/Bid continuous treatment for 21 days after TCRA.,after 11 days plus served dingosterone 1#/Bid.After next menstrual clean get on the second hysteroscopy,at the same time start the second cycle of medication(method with the former),a total of three cycles.Severe patients were also treated with estradiol valerate 2#/Bid continuous treatment for three consecutive cycles,in the last 10 days plus diclofenac 1 tablet/Bid,severe patients underwent secondary intrauterine exploration after 1 month.Second hysteroscopy with the first operation,if sticky again,separate the adhesion with micro scissors.Preoperative and postoperative use of the American Fertility Association(AFS)standard on the degree of intrauterine adhesions,followed by the uterine cavity morphology when second exploration,after 12 months by second exploration the menstrual flow improved,abdominal pain relief,Re-pregnancy situation.Data processing using SPSS 17.0 statistical software,the count data and the measurement data are expressed as percentages(%),mean±standard(x±s),the data were analyzed by one-way ANOVA,counting data were compared using χ2 test,the difference was statistically significant by P<0.05.Results:According to the degree of intrauterine adhesions,80 cases were divided into three part:24 cases of mild adhesion,36 cases of moderate adhesion and 20 cases of severe adhesion.There were significant differences in TCRA scores before and after AFS in different degree of intrauterine adhesions(P<0.05),and the AFS score was significantly lower than that before operation.the overall recovery rate of uterine cavity was 85%after second operation(68/80 cases).There were 60 cases of menstrual changes(less volume + amenorrhea)before operation.The improvement rate of total menstruation in IUA patients was 90%(54/60).The effective rate was 91.3%in 26 cases with secondary infertility,and 15 cases were followed up at the end of the follow-up period.The total pregnancy rate was 57.7%.Conclusion(s):The use of micro scissors transcervical resection of adhesions is an effective treatment of intrauterine adhesions,placed water sac and using artificial cycle treatment of estrogen and progesterone can effectively avoid adhesion again,increase the amount of menstruation,increase pregnancy rate.