Clinical Observation Of Intrauterine Balloon Stent Combined With Intrauterine Device For Prevention Of Intrauterine Re-adhesion

Objective To explore the clinical efficacy of intrauterine balloon stent combined with intrauterine device in preventing re-adhesion after intrauterine adhesion separation,aiming to select a more effective treatment for clinical.Methods 78 patients who were diagnosed with moderate intrauterine adhesions and met the inclusion criteria were selected in our hospital from Apr.2017 to Oct.2018.They were divided into three groups according to the random number table method.Group A(IUD group)After the operation,the IUD was placed and was taken after 2 months;Group B(Balloon group)place the intrauterine balloon stent after surgery,inject chitosan for the second time after 5-7 days,and take out the intrauterine balloon stent;Group C(Joint group)place the intrauterine balloon stent and intrauterine device,inject of chitosan for 5-7 days after surgery and take out the balloon stent.Then check the position of the intrauterine device by B-ultrasound.Removal of intrauterine device 2 months after surgery.The three groups were injected with chitosan of 3ml in the uterine cavity in surgery and 5-7 days after surgery.The artificial cycle treatment started?2 cycles on the second day after operation.Postoperative observation of the patient's menstrual period,menstrual flow,premenstrual endometrial thickness.Secondary hysteroscopy at 2 months postoperative uterine re-adhesion.Results 1.General data comparison: The three groups of patients in terms of age,marital status,parity,number of intrauterine operations and reasons for treatment,the difference was not statistically significant(P>0.05).2.The re-adhesion rates of the three groups were 46.2% in group A,30.8% in group B,and 3.8% in group C.Group C was significantly different from group A and group B(P<0.017).3.The average scores of AFS before and after surgery were 6.69±1.01 and 2.27±2.71 in group A,6.50±0.91 and 1.38±2.35 in group B,7.01±0.93 and 0.15±0.78 in group C.There were significant differences in postoperative and preoperative between the groups.(P<0.05).The AFS score of group C was significantly lower after operation compared with group A and group B(P<0.017).4.The improvement of menstrual flow in the 2 months after operation: 76.9% in group A and 88.5% in group B.The C group had different degrees of improvement.The group C had a significant difference compared with group A and group B(P<0.017).5.The average number of days before and after the menstrual period was 3.00±0.94,4.04±0.72 in group A,2.73±0.87 and 4.50±1.07 in group B,2.85±0.73 and 5.19±0.75 in group C.There were significant differences between the two groups(P<0.05).Group C was significantly different from group A and group B(P<0.017).6.Preoperative and postoperative anterior endometrial thickening was 4.80±1.13 and 6.81±1.17 in group A,4.58±1.03 and 7.19±1.10 in group B,and 4.85±1.08 and 7.92±0.98 in group C,respectively.There were significant differences between the two groups(P<0.05).Group C was significantly different from group A and group B(P<0.017).Conclusion Intrauterine balloon stent combined with intrauterine device can reduce the rate of re-adhesion,degree of adhesion(lower AFS score),significantly improve menstrual flow,menstrual period,endometrial thickness.The clinical curative effect is more significant and worthy of promotion and application.