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富血小板血浆治疗阿谢曼综合征:一项随机对照试验。

Platelet-rich plasma in the management of Asherman's syndrome: An RCT.

作者信息

Javaheri Atiyeh, Kianfar Katayoon, Pourmasumi Soheila, Eftekhar Maryam

机构信息

Department of Obstetrics and Gynecology, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.

出版信息

Int J Reprod Biomed. 2020 Feb 27;18(2):113-120. doi: 10.18502/ijrm.v18i2.6423. eCollection 2020 Feb.

Abstract

BACKGROUND

Asherman's syndrome (AS) is a rare reproductive abnormality, resulting in endometrial collapse due to aggressive or recurrent endometritis and/or curettage.

OBJECTIVE

We aimed to assess the effectiveness of using platelet-rich plasma (PRP) to lower the recurrence rate of intrauterine adhesions (IUAs) following hysteroscopy.

MATERIALS AND METHODS

In this non-randomized clinical trial, women aged 20-45 years with AS diagnosed by sonohysterography, 3D sonography, hysteroscopy, or uterosalpingography between May 2018 and September 2018 were included. Participants (n = 30) were divided into case and control groups. Following hysteroscopic adhesiolysis, a Foley catheter was placed into the uterine cavity in all women. After two days, the catheter was removed, and 1-mL PRP was injected into the uterine cavity of women in the PRP (case) group, while the control received no PRP. All controls and subjects underwent diagnostic hysteroscopy 8-10 weeks following the intervention to assess the IUAs according to the American Society for Reproductive Medicine scoring system.

RESULTS

Our results did not reveal any significant difference in the menstrual pattern of either the control or test groups before or after treatment (p = 0.2). Moreover, the IUA stage in both studied groups before and after treatment was similar (p = 0.2). The duration of menstrual bleeding in both studied groups before and after treatment was also similar.

CONCLUSION

PRP cannot change the menstrual pattern or development of postsurgical AS, as evaluated by follow-up hysteroscopy.

摘要

背景

阿谢曼综合征(AS)是一种罕见的生殖系统异常疾病,由侵袭性或复发性子宫内膜炎和/或刮宫术导致子宫内膜塌陷。

目的

我们旨在评估使用富血小板血浆(PRP)降低宫腔镜检查后宫腔粘连(IUA)复发率的有效性。

材料与方法

在这项非随机临床试验中,纳入了2018年5月至2018年9月间经子宫超声造影、三维超声、宫腔镜或子宫输卵管造影诊断为AS的20 - 45岁女性。参与者(n = 30)被分为病例组和对照组。在宫腔镜粘连松解术后,所有女性均在宫腔内放置一根 Foley 导管。两天后,取出导管,PRP(病例)组的女性在宫腔内注射1 mL PRP,而对照组未注射PRP。所有对照组和受试者在干预后8 - 10周接受诊断性宫腔镜检查,根据美国生殖医学学会评分系统评估宫腔粘连情况。

结果

我们的结果显示,治疗前后对照组或试验组的月经模式均无显著差异(p = 0.2)。此外,两个研究组治疗前后的宫腔粘连分期相似(p = 0.2)。两个研究组治疗前后的月经出血持续时间也相似。

结论

通过随访宫腔镜检查评估,PRP 不能改变术后阿谢曼综合征的月经模式或病情发展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8925/7097166/bd6af308a005/ijrb-18-113-g001.jpg

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