| Purpose: Intrauterine adhesion(intrauterine adhesion,IUA),aslo known as asherman syndrome,which refers to the uterine cavity operation and other reasons due to damage to the basal layer of the endometrium,caused by uterine cavity wall different degree of the adhesion,then lost normal uterine cavity shape and endometrial function and clinical manifestations for menstrual quantity is less,amenorrhea,periodic abdominal pain or chronic pelvic pain and infertility or abnormal pregnancy.With the development and wide application of hysteroscopy,hysteroscopic intrauterine adhesions is recognized of a based method in the treatment of severe intrauterine adhesions,with quick recovery,small damage,intuitive,efficient advantages.But recurrence rate in severe adhesion is high,especially severe adhesions after treatment is more the lack of controllability,therefore,this study intends to analyze and to compare two different methods control palace cavity adhesions,uterine cavity adhesion recovery,menstruation and pregnancy rate differences that are three aspects,thus compare curative effect.Method: Retrospective analysis of clinical data of 136 cases of patients with moderate intrauterine adhesion in Dalian maternal and child health care hospital in September2012-September 2014.Will be divided into two groups,the balloon and intrauterine device(Intrauterine device IUD),lost 12 cases.Balloon group after intrauterine adhesions by placing the balloon a week and taking orally estradiol valerate two methods combined with prevention of recurrent adhesions;IUD group for postoperative placed IUD and oral valproic acid estradiol two methods combined with prevention of adhesion recurrence occurred,this group as the control group.Two groups of general elements comparison was not statistically significant,no significant difference(P > 0.05),mean age: balloon group 3.34±5.134 years old,IUD group 31.6±5.289 years old;pregnancy time: balloon group 2.66±1.645,IUD group 2.12±1.511;production time: balloon group 0.15±0.357,IUD group0.1±0.306;number of uterine cavity operation: balloon group 1.57±1.137,IUD group 1.74±1.205,the two groups have comparability.1 months later after endoscopic examination according to the 1988 American Fertility Society score standard of type of uterine cavity adhesion,adhesion involving the palace cavity,menstrual were recorded and compared.At the same time,the operation after a full-term pregnancy were closely followed up.This study used the independent sample T test,P < 0.05 can be considered to have statistical significance.Result:1.Postoperative review intrauterine adhesions: 1 months after the review of balloon group: 4 cases of moderate adhesion,1cases increased,and re adhesion rate of 7.7%;IUD group: 10 cases of uterine cavity again moderate adhesion,3 cases increased,re adhesion rate of 22.0%.In the two group,the rate of recurrence was lower(P<0.05)than that of the IUD group,and there was statistical significance.2.Menstruation recovery: the balloon group: 57 people healing,6 people taking a turn for the better,2 people invalid,the total effective rate of 96.9%;IUD group: 43 people healing,11 people taking a turn for the better,5 invalid,the total efficiency of 91.5%.In the two group,compared with the group,the balloon group was better than the IUD group,the comparison was statistically significant(P<0.05).3.Follow up of term pregnancy: 15 to 24 months.The cases of natural pregnancy or artificial assisted pregnancy were followed up by telephone or clinic follow-up every year.Balloon group has 52 cases of fertility requirements,including 28 cases of pregnancy,pregnancy rate in 53.8%,IUD group of 50 cases,including 17 cases of pregnancy,pregnancy rate in 34%.Compared with the two groups,the prognosis of the balloon group was good,and the comparison was statistically significant(P<0.05).Conclusion: This study in intrauterine adhesions after a week using placed balloon and estradiol valerate combined preventing adhesion,the degree of adhesion was significantly lower than that of the control group,recovery of menstruation and reproductive prognosis was significantly higher than the control group,the clinical effect of satisfaction,worthy of clinical promotion. |
