Lancet M, Mass N
Int J Fertil. 1981;26(4):267-72.
Intrauterine adhesions (IUA) (Asherman's syndrome) are a relatively frequent sequel of curettage and may cause fertility problems. Diagnosis is by hysterography, and hitherto treatment was by blind division or curettage. Lately hysteroscopic division has been introduced. A few weeks later re-hysterography is done to evaluate the results. A one-stage method is presented, in which hysteroscopic division of adhesions and immediate hysterography are done on the operating table. If some adhesions are still seen, repeat hysteroscopy and adhesionolysis re done, until the uterine cavity is restored to normal. A Lippes IUD is inserted for 2 months, with cyclic hormonal treatment, and the patient allowed subsequently to become pregnant. Fifty-six patients were treated in this manner and in 53 a regular cavity was obtained. Obstetric performance was improved from 31.9% to 64.9%, so that anatomical and functional results compare very favorably with previous reports that used other methods. This one-stage method offers a short and efficient treatment of IUA.
宫腔粘连（IUA）（阿谢曼综合征）是刮宫术后相对常见的后遗症，可能导致生育问题。诊断依靠子宫输卵管造影术，迄今为止，治疗方法是盲目分离或刮宫。最近引入了宫腔镜下分离术。几周后再次进行子宫输卵管造影术以评估结果。本文介绍了一种一期手术方法，即在手术台上进行宫腔镜下粘连分离术并立即进行子宫输卵管造影术。如果仍可见一些粘连，则重复宫腔镜检查并再次进行粘连分解术，直到子宫腔恢复正常。放置Lippes宫内节育器2个月，并进行周期性激素治疗，随后允许患者怀孕。56例患者采用这种方法治疗，其中53例子宫腔恢复正常。产科结局从31.9%提高到64.9%，因此，与以往使用其他方法的报道相比，解剖和功能结果非常理想。这种一期手术方法为宫腔粘连提供了一种简短而有效的治疗方法。
