Pongpattanawut Chanrit, Pantasri Tawiwan, Sreshthaputra Opas, Sanmee Usanee
J Med Assoc Thai. 2016 Oct;99(10):1067-72.
To explore the causes and treatment outcomes of intrauterine adhesions among Thai women.
This retrospective cross-sectional study recorded and analyzed the demographic data, causes, and treatment outcomes of 75 patients who underwent hysteroscopic adhesiolysis between January 2004 and June 2015 at Maharaj Nakhon Chiang Mai Hospital, Chiang Mai, Thailand.
The most common etiology of intrauterine adhesions was a history of early pregnancy termination by curettage (68%). Sixty-nine percent of the patients had menstrual abnormalities. Twenty-two percent of the patients had severe adhesions. Tuberculous endometritis caused the most severe case. Sharp hysteroscopic adhesiolysis improved the condition in 77.7% of the patients. The outcomes of the patients with mild to moderate IUA were better than those with severe intrauterine adhesions (88.2% vs. 43.8%, respectively) (p = 0.001). Fifty-one patients planned to conceive, and 49% succeeded after hysteroscopic surgery.
Menstrual abnormalities were the most common presentation of intrauterine adhesions. The most common cause of intrauterine adhesions was early pregnancy termination by curettage. However, tuberculosis endometritis caused the most severe case. Hysteroscopic adhesiolysis significantly improves menstrual function and fertility outcomes; mild to moderate cases have a better prognosis.
探讨泰国女性宫腔粘连的病因及治疗效果。
这项回顾性横断面研究记录并分析了2004年1月至2015年6月期间在泰国清迈玛哈叻清迈医院接受宫腔镜粘连松解术的75例患者的人口统计学数据、病因及治疗效果。
宫腔粘连最常见的病因是刮宫所致早期妊娠终止史（68%）。69%的患者有月经异常。22%的患者有严重粘连。结核性子宫内膜炎导致了最严重的病例。锐性宫腔镜粘连松解术使77.7%的患者病情得到改善。轻度至中度宫腔粘连患者的治疗效果优于重度宫腔粘连患者（分别为88.2%和43.8%）（p = 0.001）。51例患者计划怀孕，宫腔镜手术后49%成功受孕。
月经异常是宫腔粘连最常见的表现。宫腔粘连最常见的病因是刮宫所致早期妊娠终止。然而，结核性子宫内膜炎导致了最严重的病例。宫腔镜粘连松解术显著改善月经功能和生育结局；轻度至中度病例预后较好。
