摘要 目的?探讨宫腔粘连患者宫腔镜下宫腔粘连分离术(transcervical resection of adhesions，TCRA)术后应用Foley球囊+自交联透明质酸钠凝胶预防术后再粘连的临床效果。方法?选取我院在2015年12月至2017年11月收治的中重度宫腔粘连患者120例，按照随机数字表法分为观察组和对照组，每组各60例；观察组在TCRA术后应用Foley球囊+自交联透明质酸钠凝胶预防再粘连；对照组在TCRA术后应用Foley球囊+普通医用透明质酸钠凝胶预防再粘连。术后3个月观察两组患者临床疗效及AFS评分、粘连范围、粘连类型、月经状况及再粘连状况。结果?治疗后观察组临床有效率为86.67%(52/60)，对照组临床有效率为71.67%(43/60)，比较具有统计学差异(χ2=4.093,P<0.05)；术后3个月宫腔镜检查两组患者AFS总分、粘连范围评分、粘连类型及月经状况评分较术前均明显下降(P<0.05)；观察组AFS总分、月经状况评分明显低于对照组，差异具有统计学意义(P<0.05)；两组患者术后粘连范围、粘连类型比较差异无统计学意义(P>0.05)；术后3个月宫腔镜检查，观察组术后再粘连发生率为1.92%(1/52)，对照组术后再粘连发生率为16.28%(7/43)，比较具有统计学差异(χ2=4.566,P<0.05)。结论?宫腔粘连患者TCRA术后应用Foley球囊+自交联透明质酸钠凝胶预防粘连效果显著，能够有效降低AFS评分及月经状况，值得临床推广。
Abstract: Objective?To investigate the clinical effect of Foley balloon+self-crosslinked sodiumhyaluronate gel for preventing postoperative adhesions after TCRA in patients with intrauterine adhesions.Methods?A total of 120 patients with moderate-severe intrauterine adhesions were selected from December，2015 to November，2017 in ourhospital.According to the random number table,the patients weredivided into the observation group and the control group,with 60 cases in each.The observation group was treated with TCRA Foley balloon+self-crosslinked sodiumhyaluronate gel to prevent re-adhesion,and the control group was treated with TCRA Foley balloon+ordinary medical sodiumhyaluronate gel to prevent re-adhesion.The clinical efficacy and AFS scores were observed.Results?The total AFS score,adhesion area score,adhesion type and menstrual status score of the two groups were significantlydecreased (P<0.05) 3 months after thehysteroscopy; and the AFS score and the menstrual status score of the observation group were significantly lower than that of the control group(P<0.05).After treatment,the clinical effective rate was 86.67%(52/60) in the observation group and 71.67%(43/60) in the control group with statistical significance (χ2= 4.093,P<0.05).The incidence of re-adhesion was 1.92%(1/52) in the observation group and 16.28% (7/43) in the control group 3 months afterhysteroscopy.There was a statistically significantdifference between the two group(χ2=4.566,P<0.05).Conclusion?The application of Foley balloon+self-crosslinked sodiumhyaluronate gel to prevent adhesion in patients with intrauterine adhesions after TCRA is effective in reducing the AFS score and menstrual status,which is worthy of clinical promotion.
王润，欧红，阮艳. TCRA术后Foley球囊+自交联透明质酸钠凝胶在宫腔粘连患者中的应用效果[J]. 中国现代手术学杂志, 2018, 22(1): 67-71.
WANG Run. Effects of Foley Balloon and Self-crosslinked Sodium Hyaluronate Gel after TCRA in Patients withIntrauterine Adhesions. Chinese Journal of Modern Operative Surgery, 2018, 22(1): 67-71.
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2018, Vol. 22 
