Ma Junyan, Zhan Hong, Li Wen, Zhang Liqi, Yun Feng, Wu Ruijin, Lin Jun, Li Yangyang
Zhejiang Provincial Key Laboratory for Precision Diagnosis & Treatment of Major Gynecological Diseases, Hangzhou, 310006, Zhejiang Province, China.
Department of Gynecology and Obstetrics, Women' s Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang Province, China.
Biomater Res. 2021 Nov 24;25(1):40. doi: 10.1186/s40824-021-00242-6.
Intrauterine adhesion (IUA) is a common gynaecological disease that develops from infection or trauma. IUA disease may seriously affect the physical and mental health of women of childbearing age, which may lead to symptoms such as hypomenorrhea or infertility. Presently, hysteroscopic transcervical resection of adhesion (TCRA) is the principal therapy for IUAs, although its function in preventing the recurrence of adhesion and preserving fertility is limited. Pharmaceuticals such as hormones and vasoactive agents and the placement of nondegradable stents are the most common postoperative adjuvant therapy methods. However, the repair of injured endometrium is relatively restricted due to the different anatomical structures of the endometrium. Recently, the treatment outcome of IUAs has improved with the advancement of hysteroscopic techniques. In particular, the application of bioactive scaffolds combined with tissue engineering technology has proven to have high therapeutic potential or endometrial repair in IUA treatment. Herein, this review has summarized past therapeutic strategies, including postoperative adjuvant therapy, cell or therapeutic molecular delivery therapy methods and bioactive scaffold-based tissue engineering methods. Therefore, this review presented the recent therapeutic strategies for repairing endometrium treatment and pointed out the issues of clinical concern to provide alternative methods for the management of IUAs.
宫腔粘连(IUA)是一种由感染或创伤引起的常见妇科疾病。IUA疾病可能严重影响育龄妇女的身心健康,可能导致月经过少或不孕等症状。目前,宫腔镜下宫颈粘连切除术(TCRA)是IUA的主要治疗方法,尽管其在预防粘连复发和保留生育能力方面的作用有限。激素和血管活性药物等药物以及不可降解支架的放置是最常见的术后辅助治疗方法。然而,由于子宫内膜的解剖结构不同,受损子宫内膜的修复相对受限。近年来,随着宫腔镜技术的进步,IUA的治疗效果有所改善。特别是,生物活性支架与组织工程技术相结合的应用已被证明在IUA治疗中对子宫内膜修复具有很高的治疗潜力。在此,本综述总结了过去的治疗策略,包括术后辅助治疗、细胞或治疗分子递送治疗方法以及基于生物活性支架的组织工程方法。因此,本综述介绍了修复子宫内膜治疗的最新治疗策略,并指出了临床关注的问题,为IUA的管理提供替代方法。