腹部B超联合宫腔镜治疗重度宫腔粘连的评价

Evaluation of Abdominal Ultrasonography Combined with Hysteroscopy in the Treatment of Severe Intrauterine Adhesion

摘要: 目的：探讨腹部B超联合宫腔镜治疗重度宫腔粘连患者的治疗效果。方法：回顾性分析2017年4月至2020年4月在本院行宫腔镜重度宫腔粘连分离术的患者60例，其中B超监视组21例，常规组39例，通过比较两组术后的月经恢复情况、宫腔粘连改善情况、AFS评分、手术时间、出血量评估治疗效果。结果：B超监视组月经恢复的总有效率为90.5%，高于常规组的64.1%，差异有统计学意义(P < 0.05)，B超监视组AFS评分中位数为2分，P25为2分，P75为4分，常规组中位数为5分，P25为4分，P75为6分，B超监视组低于常规组，差异有统计学意义(P < 0.05)，宫腔恢复情况、出血量、手术时间两组差异无统计学意义。结论：腹部B超监视下行宫腔镜重度宫腔粘连分离术可明显改善月经恢复情况，提高宫腔粘连的疗效，可在临床上应用推广。

Abstract: Objective: To evaluate the clinical efficacy of abdominal ultrasound combined with hysteroscopy in the treatment of patients with severe intrauterine adhesion. Methods: 60 patients who underwent hysteroscopic severe uterine adhesion separation in our hospital from April 2017 to April 2020 were analyzed retrospectively, including B-ultrasound monitoring group (n = 21) and routine group (n = 39). The therapeutic effect was evaluated by comparing the recovery of menstruation, improvement of uterine adhesion, AFS score, operation time and bleeding volume between the two groups. Results: The total effective rate of menstruation recovery in the B-ultrasound monitoring group was 90.5%, which was significantly higher than that in the routine group (64.1%). The median AFS score of the B-ultrasound monitoring group was 2, P25 was 2, and P75 was 4. The median score of the routine group was 5, P25 was 4, P75 was 6, and the difference was statistically significant (P < 0.05). There was no significant difference in uterine cavity recovery, blood loss and operation time between the two groups. Conclusion: Hysteroscopic separation of severe uterine adhesion under the monitoring of abdominal B-ultrasound can significantly improve the recovery of menstruation and improve the curative effect of uterine adhesion, which can be applied and popularized in clinic.