Tchounzou R, Ngono M, Moifo B, Mbu R Enow
Gynécologie-obstétrique, hôpital régional de Limbe, Mile One, Limbe, Cameroun.
Gynécologie-obstétrique, hôpital de district de Logbaba, Douala, Cameroun.
Med Sante Trop. 2014 Jul-Sep;24(3):263-5. doi: 10.1684/mst.2014.0340.
We evaluated the outcome of treatment of uterine synechiae (or adhesions, also known as Asherman syndrome) by cervical dilatation and sequential estrogen and progestogen administration for three months. This retrospective cohort study examined records of 86 women with infertility or menstrual disorders or both and treated from October 2004 to November 2011 for synechiae diagnosed by hysterosalpingography. The data analyzed included age, presenting complaint, and treatment outcome. During the study period, 86 women were seen for uterine synechiae but only 81 files could be included. The patients' mean age was 25.52 (range: 19-40 years), with 37% in the age group of 25-29 years. Of these 82 women, 71 reported menstrual disorders and 60 infertility. After treatment, 11/60 (18%) became pregnant and 35/71 (49%) recovered normal menstrual profiles. The reference treatment for uterine synechiae is hysteroscopy, which yields good results. In poor settings, however, hysteroscopy remains inaccessible, and the old method of cervical dilation and sequential estrogen and progestogen therapy is an acceptable alternative.
我们评估了通过宫颈扩张以及连续三个月给予雌激素和孕激素治疗子宫粘连(或粘连,也称为阿谢曼综合征)的疗效。这项回顾性队列研究检查了86例患有不孕症或月经紊乱或两者皆有的女性的记录,这些女性于2004年10月至2011年11月期间因子宫输卵管造影诊断出的粘连而接受治疗。分析的数据包括年龄、就诊主诉和治疗结果。在研究期间,有86名女性因子宫粘连前来就诊,但仅81份病历被纳入。患者的平均年龄为25.52岁(范围:19 - 40岁),其中25 - 29岁年龄组的占37%。在这82名女性中,71名报告有月经紊乱,60名有不孕症。治疗后,60名不孕症患者中有11名(18%)怀孕,71名月经紊乱患者中有35名(49%)恢复了正常月经模式。子宫粘连的标准治疗方法是宫腔镜检查,其效果良好。然而,在条件较差的地区,宫腔镜检查仍然无法开展,而宫颈扩张及连续雌激素和孕激素治疗的旧方法是一种可接受的替代方案。