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激素治疗联合或不联合富血小板血浆(PRP)治疗阿谢曼综合征:一项随机临床试验

Hormone Therapy with or without Platelet-Rich Plasma (PRP) for Treatment Asherman Syndrome; A Randomized Clinical Trial.

作者信息

Naghshineh Elham, Rouholamin Safoura, Derakhshandeh Zahra

机构信息

Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Adv Biomed Res. 2023 Jan 27;12:17. doi: 10.4103/abr.abr_411_21. eCollection 2023.

Abstract

BACKGROUND

Asherman syndrome is a controversial issue in obstetrics and gynecology without any consensus on its management and treatment. It is characterized by variable lesions inside the uterine cavity and also causes menstrual irregularities, infertility, and placental abnormalities. The study aimed to assess the platelet-rich plasma (PRP) effect in women with intrauterine adhesions by evaluating the improvement of the menstrual cycle and intrauterine adhesion (IUA) stage.

MATERIALS AND METHODS

This clinical trial study was performed on 60 women with Asherman syndrome in two groups of 30. For the first group, only hormone therapy was performed and for the second group, hormone therapy with platelet-rich plasma after hysteroscopy. Recovery of Asherman syndrome and IUA stage was assessed at 6 to 8 weeks after hysteroscopy and compared between the two groups.

RESULTS

Our results demonstrated that there was no significant difference between demographic data in the two groups as well as the menstrual pattern of both groups before or after treatment ( > 0.05). Frequency distribution of IUA after the intervention in the PRP + hormone therapy group in grade I, II, and III were equal to 73.3%, 20%, and 6.7% and in the hormone therapy group were 53.3%, 26.7%, and 20%, respectively ( = 0.22). In addition, hypo menorrhea was observed in 33.3% of PRP + hormone therapy group and 40% of the hormone therapy group with no significant difference between the two groups ( = 0.71).

CONCLUSION

Hormone therapy with PRP compared to hormone therapy alone after routine surgical treatment had not a significant effect on the IUA stage, duration, and severity of menstruation.

摘要

背景

阿谢曼综合征是妇产科领域一个存在争议的问题,对于其管理和治疗尚无共识。其特征是宫腔内存在多种病变,还会导致月经不调、不孕和胎盘异常。本研究旨在通过评估月经周期和宫腔粘连(IUA)分期的改善情况,来评估富血小板血浆(PRP)对宫腔粘连女性的影响。

材料与方法

本临床试验研究对60例阿谢曼综合征女性进行,分为两组,每组30例。第一组仅进行激素治疗,第二组在宫腔镜检查后进行激素治疗加富血小板血浆治疗。在宫腔镜检查后6至8周评估阿谢曼综合征和IUA分期的恢复情况,并在两组之间进行比较。

结果

我们的结果表明,两组的人口统计学数据以及治疗前后两组的月经模式均无显著差异(>0.05)。PRP+激素治疗组干预后IUA在I级、II级和III级的频率分布分别为73.3%、20%和6.7%,激素治疗组分别为53.3%、26.7%和20%(=0.22)。此外,PRP+激素治疗组33.3%的患者和激素治疗组40%的患者出现月经过少,两组之间无显著差异(=0.71)。

结论

与常规手术治疗后单独使用激素治疗相比,激素治疗加PRP对IUA分期、月经持续时间和严重程度没有显著影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/31cb/10012034/a83a2e55c856/ABR-12-17-g001.jpg

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