王云娥

[摘要] 目的 比较宫安康与球囊联合宫内节育器对宫腔镜电切术后宫腔粘连的预防效果。 方法 选取我院妇科2017年9月～2019年9月的86例宫腔镜电切术患者，根据术后宫腔粘连不同预防方法将其分为A组与B组，每组43例，A组应用宫安康，B组应用球囊联合宫内节育器，对比两组患者的AFS评分、子宫内膜厚度、宫腔粘连发生情况、月经恢复情况以及并发症发生情况。 结果 两组治疗后的AFS评分、子宫内膜厚度、宫腔粘连发生率、月经恢复率均相当（P>0.05）;A组的并发症发生率（6.98%）低于B组（18.60%）（P<0.05）。 结论 宫安康与球囊联合宫内节育器对宫腔镜电切术后宫腔粘连的预防效果相近，均可明显降低AFS评分，增加子宫内膜厚度，月经恢复率高，且宫腔粘连发生率低;但宫安康的并发症发生率低于球囊联合宫内节育器，安全性更高，值得临床应用。

[关键词] 宫安康;球囊;宫内节育器;宫腔镜电切术;宫腔粘连;预防效果

[中圖分类号] R713.4          [文献标识码] B          [文章编号] 1673-9701（2020）18-0074-04

Comparison of preventive effect between Gong-an-kang and balloon combined with intrauterine device on intrauterine adhesion after hysteroscopic electroresection

WANG Yun'e

Department of Obstetrics and Gynecology， Quanzhou Decheng Hospital in Fujian Province， Quanzhou   362100， China

[Abstract] Objective To compare the preventive effect between Gong-an-kang and balloon combined with intrauterine device on intrauterine adhesion after hysteroscopic electroresection. Methods 86 cases of hysteroscopic electroresection patients in the Department of Gynecology in our hospital from September 2017 to September 2019 were selected and divided into group A and B according to different prevention methods for postoperative intrauterine adhesions， with 43 cases in each group. Group A was treated with Gong-an-kang and group B was treated with balloon combined with intrauterine device. The AFS score， endometrial thickness， occurrence of intrauterine adhesion， menstrual recovery and complications were compared between the two groups. Results After treatment， the AFS score， endometrial thickness， incidence of intrauterine adhesion and menstrual recovery rate were similar between two groups（P>0.05）. The incidenceof complications（6.98%） in group A was lower than 18.60% in group B（P<0.05）. Conclusion Gong-an-kang and balloon combined with intrauterine device have similar preventive effects on intrauterine adhesion after hysteroscopic electroresection， which can significantly reduce AFS score， increase endometrial thickness. They have high menstrual recovery rate and lowintrauterine adhesion rate. But the complication rate of Gong-an-kang is lower than that of balloon combined with IUD， which is more safe and worthy of clinical application.

[Key words] Gong-an-kang; Balloon; Intrauterine device; Hysteroscopic electroresection; Intrauterine adhesion; Preventive effect

子宫内膜息肉、子宫黏膜下肌瘤、宫腔粘连属于妇科常见病，前两者可导致经量增多，月经不规则;宫腔粘连主要因内膜损伤引起宫腔阻塞所致[1]。该病可导致患者出现月经紊乱、不孕、反复流产等严重后果，应引起重视，有效防治。宫腔镜电切术是临床治疗子宫内膜息肉、子宫黏膜下肌瘤、宫腔粘连的常用术式，效果确切，可切除宫腔息肉，切除黏膜下肌瘤，并针对性分离粘连，有效改善宫腔状况，快速恢复月经周期;但不足的是，该术式可引起宫腔粘连，尤其对于中重度宫腔粘连患者而言，术后采取有效的方法预防宫腔粘连尤为重要[2-3]。球囊与宫内节育器等物理屏障预防粘连是临床常用手段，效果尚可，但并发症发生率较高，易引发感染、子宫穿孔、不规则出血等不良情况[4]。因此，探讨一种有效、安全的预防方法极有必要。鉴于……