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研究胎物残留后子宫黏连的现状及雌孕激素序贯疗法联合 Foley 球囊预防的效果。

To study the current status of uterine adhesions after fetal residue and the preventive effect of using estrogen and progesterone sequential therapy combined with Foley balloon.

机构信息

Department of Gynecology, Jinhua People's Hospital, Jinhua City, Zhejiang Province, China.

出版信息

Medicine (Baltimore). 2022 Sep 9;101(36):e30418. doi: 10.1097/MD.0000000000030418.

Abstract

To investigate the current status of uterine adhesions in patients with residual fetus and analyze the preventive effect of estrogen and progesterone sequential therapy combined with Foley balloon. Eighty-six patients with residual fetus were divided into control group and observation group. On the basis of the treatment plan of the control group, the observation group received estrogen and progesterone sequential therapy combined with Floey balloon treatment. Clinical efficacy, postoperative recovery status (abdominal pain duration, vaginal bleeding duration, vaginal bleeding volume, refluid time), the incidence of intrauterine adhesions, uterine hemodynamics (uterine artery systolic maximum blood flow rate [Vmax], end diastolic blood flow rate [Vmin], resistance index [RI]), and the probability of complications were evaluated. Compared with the control group, the observation group achieved higher curative effect (P < .05); the observation group had shorter duration of abdominal pain, vaginal bleeding and refluid time, and lower vaginal bleeding (P < .05); the probability of intrauterine adhesions is lower (P < .05); before treatment, there is little difference in the levels of Vmax, Vmin, RI, and other indicators between the 2 groups (P > .05). After treatment, compared with the control group, the observation group Vmax, Vmin, and other indicators, the level was significantly lower, and the RI level was significantly higher (P < .05); the observation group had a lower probability of complications (P < .05). The likelihood of uterine adhesions after fetal remains is increased. The use of estrogen and progesterone sequential therapy in conjunction with Foley balloon therapy can improve treatment efficacy, improve uterine adhesion prevention, and promote patient recovery after surgery.

摘要

探讨宫腔残留患者宫腔粘连现状,分析雌激素与孕激素序贯疗法联合 Foley 球囊在其中的预防效果。选取宫腔残留患者 86 例,分为对照组和观察组。在对照组治疗方案基础上,观察组加用雌激素与孕激素序贯疗法联合 Foley 球囊治疗。评价临床疗效、术后恢复情况(腹痛持续时间、阴道出血持续时间、阴道出血量、再引流时间)、宫腔粘连发生率、子宫血流动力学(子宫动脉收缩期最大血流速度[Vmax]、舒张末期血流速度[Vmin]、阻力指数[RI])、并发症发生概率。观察组治疗总有效率高于对照组(P < .05);观察组腹痛持续时间、阴道出血持续时间、再引流时间、阴道出血量均低于对照组(P < .05);观察组宫腔粘连发生率低于对照组(P < .05);治疗前,两组 Vmax、Vmin、RI 等指标水平差异无统计学意义(P > .05);治疗后,观察组 Vmax、Vmin 等指标水平低于对照组,RI 水平高于对照组(P < .05);观察组并发症发生率低于对照组(P < .05)。宫腔残留后发生宫腔粘连的可能性增加。雌激素与孕激素序贯疗法联合 Foley 球囊治疗可提高治疗效果,提高宫腔粘连预防效果,促进患者术后恢复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef0a/10980445/b17a606440ca/medi-101-e30418-g001.jpg

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