宫腔粘连分离术联合雌孕激素序贯疗法治疗宫腔粘连的效果-现代医学

宫腔粘连分离术联合雌孕激素序贯疗法治疗宫腔粘连的效果

单位：长沙生殖医学医院妇科, 湖南长沙 410000

分类号：R711.74

出版年·卷·期（页码）：2019·47·第八期（997-1000）

摘要：

目的：探讨宫腔粘连分离术联合雌孕激素序贯疗法治疗宫腔粘连的临床疗效。方法：选取2016年1至10月本院收治的行宫腔粘连分离术的40例宫腔粘连患者为研究组。另选取本院同期收治的进行宫腔镜手术，非宫腔粘连且子宫内膜正常患者40例为对照组。两组均进行宫腔镜手术，研究组术后接受雌孕激素序贯疗法。比较两组子宫内膜组织中雌激素受体（ER）、孕激素受体（PR）的表达水平；比较ER、PR不同表达水平的研究组患者的临床疗效；观察研究组治疗前后月经量、宫腔粘连评分、子宫内膜厚度。记录研究组治疗期间并发症发生情况。结果：研究组子宫内膜组织中ER表达水平明显高于对照组，差异有统计学意义（P<0.01）。研究组治疗后月经量明显增加、宫腔粘连评分明显降低、子宫内膜厚度明显增加。ER高表达的宫腔粘连患者，治疗的总有效率明显高于ER低表达的患者，差异有统计学意义（P<0.05）。结论：宫腔粘连患者子宫内膜组织中的ER表达高于正常子宫内膜，且ER的表达水平与疗效呈正相关，为宫腔粘连分离术联合雌孕激素序贯疗法治疗提供了一定的理论依据。

Objective:To explore clinical effect of transcervical resection of adhesion(TCRA) combined with estrogen-progesterone sequential therapy on intrauterine adhesions. Methods:In this study, 40 patients with cervical adhesion were selected as study group from January 2016 to October 2016. In addition, there were 40 cases of non-uterine adhesion and endometrial normal patients in the control group. Both groups underwent hysteroscopic surgery, and the study group received estrogen-progesterone sequential therapy after surgery. The expression levels of ER and PR in endometrial tissues were compared in the two groups. The clinical efficacy of patients with different levels of ER and PR was compared. In the study group, the menstrual flow, cervical adhesion score and endometrialthickness were evaluated. The complications were recorded during the treatment of the study group. Results:The expression level of ER in endometrial tissue of the study group was significantly higher than that in the control group, and the difference was statistically significant (P<0.01). After the treatment of the study group, the menstrual volume increased significantly, the cervical adhesion score decreased significantly, and the endometrial thickness increased significantly. The total effective rate in patients with higher ER expression was higher than the patient with low ER expression, the difference was statistically significant (P<0.05). Conclusion:The expression of ER in endometrium of patients with uterine adhesion is higher than that of normal uterus, and the expression level of ER is positively correlated with the curative effect, which provides a theoretical basis for the treatment of uterine adhesion separation combined with estrogen and progesterone sequential therapy.

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