Revaux A, Ducarme G, Luton D
Service de chirurgie gynécologique et d'obstétrique, université Paris-VII, hôpital Beaujon, Assistance publique-Hôpitaux de Paris (AP-HP), 100 boulevard du Général-Leclerc, Clichy, France.
Gynecol Obstet Fertil. 2008 Mar;36(3):311-7. doi: 10.1016/j.gyobfe.2007.11.014. Epub 2008 Mar 4.
Intrauterine adhesions are the most frequent complications after hysteroscopic surgery in women of reproductive age. The prevalence of intrauterine adhesions after hysteroscopic surgery is correlated to intrauterine pathology (myoma, polyp, or adhesions). Few clinical trials have demonstrated the efficiency of barrier agents developed in order to prevent adhesions after operative hysteroscopy. Adhesion barriers are mechanic agent (intrauterine device), fluid agents (Seprafilm, Hyalobarrier) and postoperative systemic treatment (estroprogestative treatment). In this article, we evaluate the efficiency of these barrier agents for adhesion prevention in hysteroscopic surgery, undertaking a review of clinical trials published. The most frequent published studies evaluate the anatomic efficiency of antiadhesion agents after hysteroscopic surgery in order to evaluate the fertility. Data are still insufficient to evaluate them for clinical use. There is a need for other randomised controlled trials.
宫腔粘连是育龄期女性宫腔镜手术后最常见的并发症。宫腔镜手术后宫腔粘连的发生率与宫腔病变（肌瘤、息肉或粘连）相关。很少有临床试验证明为预防宫腔镜手术后粘连而研发的屏障剂的有效性。粘连屏障剂包括机械性制剂（宫内节育器）、液体性制剂（Seprafilm、透明质酸屏障）和术后全身治疗（雌孕激素治疗）。在本文中，我们通过回顾已发表的临床试验，评估这些屏障剂在宫腔镜手术中预防粘连的有效性。已发表的研究大多评估宫腔镜手术后抗粘连剂的解剖学有效性以评估生育能力。现有数据仍不足以评估其临床应用价值。还需要进行其他随机对照试验。
