关键词： 子宫疾病   超声检查   宫颈宫腔粘连  

摘要： 宫腔粘连(IUA)是妇科常见病,严重危害女性健康。超声可清晰显示子宫内膜、宫腔形态及血流变化,为IUA诊断和治疗提供直观影像学依据。本文对超声在IUA中的应用进展进行综述。

关键词： 子宫内膜损伤   宫腔粘连分离术   重度宫腔粘连   阿司匹林   反复流产   TCR   月经减少   生育要求  

摘要： 宫腔粘连(IUA)是由于子宫内膜损伤而导致的宫腔闭塞,患者常伴有月经减少、闭经、不孕、反复流产等症状^([1])。宫腔粘连分离术(TCRA)是部分有生育要求的IUA患者首选治疗方法,但TCRA后仍有较高的复发率,对重度IUA患者的治疗效果不够理想,因此术后采取有效的措施来预防粘连复发具有重要意义^([2])。

关键词： intrauterine adhesion   risk factors   prevention and control measures  

摘要： Objective: to analyze the risk factors of intrauterine adhesions. Methods: a total of 148 patients with intrauterine adhesions admitted to Guangdong Hospital of Traditional Chinese Medicine were selected as the case group, and 84 healthy women were selected as the reference group. The data of age, pregnancy and birth, history of gynecological diseases and other data of subjects were collected, and the risk factors of intrauterine adhesions were analyzed by univariate and multivariate Logistic regression. Results: cases patients with the control group health personnel in contrast has no obvious difference between age, maternal group cases times, number of induced abortion, hysteroscopy operation times, history of department of gynaecology rate were higher than health personnel, anxiety score higher than that of health personnel, exercise frequency is lower than the health personnel, period number of sex is less than the health personnel, compare the significant difference between the two groups. Multiple logistic regression analysis showed that the number of pregnancies, the number of induced abortions, the number of uterine operations, long-term anxiety, uterine size and gynecological history were the main risk factors for intrauterine adhesions. Conclusion: the occurrence of intrauterine adhesions can be affected by various factors such as intrauterine operation, induced abortion and gynecological diseases. Correct contraception, pregnancy health protection and strengthening exercise can help prevent and control the occurrence of diseases.

关键词： apoptosis   gynecological neoplasms   human amniotic epithelial cells   ovarian function   recurrent abortion   review   uterine adhesion   人羊膜上皮细胞   凋亡   卵巢功能   复发性流产   妇科肿瘤   宫腔粘连   综述   apoptosis   gynecological neoplasms   human amniotic epithelial cells   ovarian function   recurrent abortion   review   uterine adhesion   Language of Keywords: English   Chinese  

摘要： BACKGROUND: Human amniotic epithelial cells have a wide range of biological functions and can be used in the treatment of many diseases, such as conjunctival injury, burn, pulmonary fibrosis and heart disease. Human amniotic epithelial cells have been tested in the field of obstetrics and gynecology and achieved remarkable results, which is expected to become a new disease treatment, and is worthy of in-depth research and exploration. OBJECTIVE: To review the research progress, application status and development prospect of human amniotic epithelial cells on some diseases in the field of gynecology and obstetrics. METHODS: Key words “human amniotic epithelial cells”, “tumor” and “obstetrics and gynecology” were used to search PubMed and Web of Science databases, and Wanfang and CNKI Chinese databases were searched with key words “human amniotic epithelial cells”, “gynecological tumor” and “obstetrics and gynecology”. A total of 40 articles were included according to the inclusion and exclusion criteria. RESULTS AND CONCLUSION: (1) Human amniotic epithelial cells reverse abnormal vascular structure and function and induce apoptosis of endometrial carcinoma. (2) Human amniotic epithelial cells can inhibit apoptosis of granulosa cells induced by chemotherapy and restore fertility. (3) Human amniotic epithelial cells can treat uterine adhesion and improve fertility. (4) Human amniotic epithelial cells can treat recurrent spontaneous abortion. It is believed that with the further research, the function of human amniotic epithelial cells will be more widely developed and utilized. [ABSTRACT FROM AUTHOR]

关键词： 宫腔粘连   药物疗法   性激素类  

摘要： 目的对比分析芬吗通和补佳乐分别应用于宫腔粘连分离术后对患者子宫内膜恢复的影响及其安全性。方法将本院2017年10月—2019年10月收治的80例接受宫腔粘连分离术的患者纳入研究样本,采用随机数字表法分为对照组与观察组,各40例。其中对照组患者术后立即予以补佳乐治疗,观察组则予以芬吗通治疗。比较2组患者治疗前后的宫腔粘连程度、月经、子宫内膜恢复情况以及不良反应发生情况。结果观察组患者术后3个月的宫腔粘连程度明显较对照组轻(χ^(2)=7.741,P<0.05);观察组患者术后3个月的子宫内膜厚度(9.75±1.24)mm,大于对照组的(8.31±1.06)mm(t=5.583,P<0.01),且观察组子宫内膜状态以A型(75.00%)为主,对照组以B型(64.71%)为主,2组子宫内膜状态分布差异有统计学意义(χ^(2)=6.511,P<0.05);观察组月经恢复的总有效率90.00%,高于对照组的65.00%(χ^(2)=7.169,P<0.01);观察组与对照组不良反应发生率分别为22.50%、15.00%,差异无统计学意义(χ^(2)=0.739,P>0.05)。结论宫腔粘连分离术后使用芬吗通的对患者的子宫内膜修复效果优于使用补佳乐,临床价值更高。

关键词： 宫腔粘连   宫腔声学造影   经阴道三维超声   检出率  

摘要： 目的探讨宫腔声学造影联合经阴道三维超声检测对宫腔粘连的临床价值,以期为临床诊治提供参考依据。方法选取2018年3月-2019年10月期间在湖州市妇幼保健院接受检查的129例疑似宫腔粘连患者为研究对象,所有入选者均接受宫腔声学造影及经阴道三维超声检查,并于上述两项检查结束3 d后接受宫腔镜检查,以宫腔镜检查结果作为金标准,分析宫腔声学造影联合经阴道三维超声检测对宫腔粘连的检出率及分度、分型的诊断结果及诊断效能。结果宫腔镜检查宫腔粘连检出率为98.45%,宫腔声学造影联合经阴道三维超声检查的检出率为96.90%,两种检查方法对比差异无统计学意义(P>0.05)。本次对127例宫腔镜检查确诊的宫腔粘连患者进行分度研究发现,宫腔声学造影联合经阴道三维超声检查与宫腔镜检查一致性较好,Kappa值为0.806。本次对127例宫腔镜检查确诊的宫腔粘连患者进行分型研究发现,宫腔声学造影联合经阴道三维超声检查与宫腔镜检查一致性较好,Kappa值为0.789。结论宫腔声学造影联合经阴道三维超声检测对宫腔粘连具有较高的诊断价值,可显著区分不同分型及分度的宫腔粘连,临床可推广使用。

关键词： 粘膜下子宫肌瘤   宫腔镜手术   宫腔粘连   肿瘤坏死因子  

摘要： 目的分析粘膜下子宫肌瘤患者宫腔镜术后宫腔粘连(IUA)发生状况及其影响因素。方法选择2017年6月至2020年6月我院收治的粘膜下子宫肌瘤患者60例作为研究对象,收集所有患者一般资料,分析粘膜下子宫肌瘤患者宫腔镜术后IUA发生状况及其影响因素。结果60例粘膜下子宫肌瘤患者宫腔镜术后发生IUA23例,发生率为38.33%。经单因素分析,粘膜下子宫肌瘤患者宫腔镜术后IUA发生不受年龄、产次、合并盆腔炎、剖宫产史、孕次、PCT及女性肿瘤标志物5项影响(P>0.05);但可能受人工流产史、解脲支原体阳性的影响(P<0.05)。解脲支原体阳性、人工流产史是粘膜下子宫肌瘤患者宫腔镜术后IUA发生的影响因素(OR>1,P<0.05)。结论粘膜下子宫肌瘤患者宫腔镜术后宫腔粘连发生率相对较高,解脲支原体阳性、人工流产史可能是影响粘膜下子宫肌瘤患者宫腔镜术后IUA发生的影响因素,临床可加强对上述指标的检测以降低IUA发生率。

关键词： 宫腔粘连分离术   羧甲基壳聚糖胶体平衡液   水囊导尿管  

摘要： 目的探讨宫腔粘连(IUA)分离术后宫内灌注羧甲基壳聚糖胶体平衡液(以下简称防粘液)联合留置水囊导尿管的治疗方法预防宫腔再粘连的临床效果。方法选择2019年1月至2020年9月来该院行IUA分离术的患者60例为研究对象,分为观察组、对照组,每组各30例。行IUA分离术后,于观察组患者宫腔内灌注防粘液并留置水囊导尿管7 d后取出,于对照组患者宫腔内留置节育环3个月后取出。两组患者采取同样的药物治疗方案。术后3个月,经宫腔镜检查两组患者宫腔恢复情况,同时询问患者月经恢复情况。结果观察组中,30例患者宫腔及月经均完全恢复至正常,有效率均为100.00%;对照组中,21例患者宫腔完全恢复正常,5例宫腔恢复好转,有效率为86.67%(26/30),月经恢复有效率为83.33%(25/30),两组宫腔恢复及月经恢复有效率比较,差异均有统计学意义(P<0.05)。结论IUA分离术后于患者宫内灌注防粘液联合留置水囊导尿管的治疗方法,能明显提高IUA分离术的治愈率,降低术后宫腔再粘连的风险,该技术简单、安全、易行,有良好的治疗效果。

关键词： 宫腔镜下宫腔粘连分离术   宫内节育器   医用透明质酸钠   术后再粘连  

摘要： 目的:观察用三种措施预防接受宫腔镜下宫腔粘连分离术的患者发生术后再粘连的临床效果。方法:选取2020年8月至2021年6月期间在德江县人民医院接受宫腔镜下宫腔粘连分离术的96例宫腔粘连患者为研究对象。按照治疗方法的不同将其分为A组(n=30)、B组(n=32)和C组(n=34)。术后,用雌激素、孕激素对三组患者进行治疗。在此基础上,为A组患者放置宫内节育器,为B组患者向宫腔内注射医用透明质酸钠,为C组患者放置宫内节育器并向宫腔内注射医用透明质酸钠。治疗后,对比三组患者月经的恢复情况、宫腔再粘连的发生情况及术后的妊娠情况。结果:治疗前,三组患者月经恢复情况的评分相比,P>0.05。治疗后,三组患者月经恢复情况的评分均低于治疗前,其中C组患者月经恢复情况的评分均低于A组及B组患者,P<0.05。治疗后,C组患者宫腔再粘连的总发生率均低于A组及B组患者,P<0.05。术后,三组患者中妊娠成功患者的占比相比,P>0.05。结论:为接受宫腔镜下宫腔粘连分离术的患者在应用雌激素、孕激素的同时放置宫内节育器、向宫腔内注射医用透明质酸不会提高其术后妊娠的成功率,但可促进其月经的恢复,降低其术后宫腔再粘连的发生率。