| Background and Objective With the implementation of the two-child policy,More and more families choose to have a baby,but intrauterine adhesion becomes to be a big problem to these families.intrauterine adhesions(IUA)refers to the mutual adhesion of uterine muscle wall and(or)cervical canals due to any event that causes damage to the basilar layer of the endometrium.With the development of the society,the popularity of hysteroscopy and the increased awareness,especially in CHINA.at present,the mainly treatment of intrauterine adhesion is the Comprehensive therapy,including the transcervical resection of uterine adhesion(TCRA),estrogen based drug therapy and baririer methods.However,uterine cavity easy to re-adhesion after surgery,the moderate and servere IUA is 62.5%.Therefore,how to reduce the incidence of postoperative recurrence of moderate and servere IUA and improve the treatment effect,is the main problem in clinic.In this study,Growth Hormone and Interceed which would be placed into uterine cavity was addedbased on the comprehensive treatment commonly used at present,We compared the therapeutic effect of each group to explore and analysis the clinical effect of different comprehensive methods on the treatment of moderate to severe intrauterine adhesions,hope to find more definitive and effective methods,reduce the recurrence of IUA.Object and Methods 1 Materials 72 cases of moderate to severe intrauterine adhesions from June 2015 to June 2016 in the Second Affiliated Hospital of Zhengzhou University were collected.Test method 72 patients underwent transcervical resection of adhesions.According to different treatmen methods after operation,patients were divided into three groups:in the control group,there were 24 cases(17 cases with servere adhesion,7cases with moderate adhesion),GH group has 22cases(10 cases with servere adhesion,12 cases with moderate adhesion),Interceed group has 26 cases(16 cases with servere adhesion,10 cases with moderate adhesion).All patients were treated by Comprehensive therapy,namely: To take orally E2V(Bayer healthcare Co.Ltd,lmg/ tablet)6mg every day for 21 days with the addition of medroxyprogesterone acetate(MPA)at a dose of 100 mg/day in the last 5 days as one cycle,and the treat would begin from the very next day after operation,last 3 months;intrauterine placed Foley balloon 5 days after RCRA,secondary hysteroscopy were performed,the control group was treated by chitosan.GH group was injected of growth hormone 4iu/d subcutaneously for 10 days after surgery,and fifth days of next menstrual again 10 days,a total 3 menstrual cycles.Interceed group were treated by Interceed,injected of growth hormone 4iu/d subcutaneously for 10 days after surgery,and fifth days of next menstrual again 10 days,a total 3 menstrual cycles.3 months after operation,all patients were reexamined by hysteroscopy,follow up and record the uterine cavity shape,the recovery of menstruation and endometrial thickness measured by ultrasound in tenth to fifteenth days of the third menstrual cycle after the operation.Compared with the three groups of patients before and after the operation of intrauterine adhesions,menstrual improvement and endometrial thickness in the same time of menstrual cycle.2 Statistic Analysis The data was analyzed using SPSS17.0 software.Measurement datas were described with the mean and standard deviation.To use paired t test analysed the treatment outcome in each group and used chi-square test to analyse the comparison of rate.there were significant differences as P< 0.05.Result 1 Situation of morphology of uterine cavity The effective rate of GH group reached 72.7%(16/22),The effective rate of the control group reached 41.7%(10/24),There were significant differences among them.The effective rate of GH group reached 72.7%(16/22),The effective rate of the interceed group reached 96.2%(25/26),the differences were significant.2 Endometrial thickness increase Compaired to the controu group,the endometrial thickness of GH group reached(5.97±1.93)mm,the the differences were significant.Compaired to GH group,the endometrial thickness of interceed group reached(7.55±1.89)mm,the the differences were also significant.3 Menstrual improvement Control group,GH group,intercede group,the improvement rate were 54.17%(13/24)、77.27%(17/22)、80.77%(21/26),comparison between the Control group and GH group,There were no significant differences among them.comparison between the GH group and intercede group,There were no significant differences among them.Conclusion 1.Growth hormone,combined with comprehensive therapy,can increase the endometrial thickness after TCRA,conductive to the recovery of menstruation and reduce the rate of re-adhesion.2.The therapeutic effect of Interceed absorbable adhesion barrier in the treatment of moderate to severe intrauterine adhesions is better than that by the clinical application value of chitosan.The clinical value is high. |
