医用聚乙二醇小檗碱液改善清宫术后临床结局的效果分析
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摘要
目的探讨清宫术中使用医用聚乙二醇小檗碱液(粘连平)对清宫术后临床结局的影响。方法将需要行清宫术的166例患者按其自愿选择分为实验组(80例)和对照组(86例),2组均行常规清宫术,实验组在清宫术结束后经导管向宫腔注入医用聚乙二醇小檗碱液3 mL,对照组不灌注药物,比较2组患者术后子宫内膜厚度、月经恢复情况,对于有生育要求的实验组(32例)和对照组(20例)患者随访至术后1年半并比较再次妊娠情况。结果实验组术后子宫内膜厚度为(9. 44±1. 95) mm,显著厚于对照组(8. 65±2. 28) mm(P <0. 05),实验组术后内膜<8 mm患者占比为27. 5%(22/80),显著低于对照组的38. 4%(33/86)(P <0. 01);实验组术后月经量减少患者占比为10. 0%(8/80),较对照组16. 3%(14/86)低,但无显著差异(P> 0. 05);实验组术后有生育要求患者的正常妊娠率为93. 75%(30/32),显著高于对照组的70. 00%(14/20)(P <0. 05)。结论清宫术中宫腔灌注医用聚乙二醇小檗碱液可促进患者术后子宫内膜修复,提高术后正常妊娠率,操作简单,依从性好,是一种有效的改善清宫术后临床结局的方法。
Objective To explore the effect of medical polyethylene glycol berberine on clinical outcomes after curettage. Methods A total of 166 curettage patients were divided into study group( n = 80) and control group( n = 86) by the patients' willingness. The two groups were given routine curettage,and the study group were additionally given 3 mL medical polyethylene glycol berberine by uterine cavity injection,while the control group infused no drugs. The postoperative endometrial thickness,menstruation situation were compared,and the re-pregnancy conditions of the patients in control group( n = 20) and experimental group( n = 32) with two-child requirement at follow-up and in one and a half year after follow-up were compared. Results The endometrial thickness in the study group was thicker than that in the control group [( 9. 44 ± 1. 95) mm vs.( 8. 65 ± 2. 28) mm,P < 0. 05],the proportion of the endometrial thickness < 8 mm in the study group was lower than that in the control group[27. 5%( 22/80) vs. 38. 4%( 33/8),P < 0. 01]. The ratio of patients with eumenorrhea was lower than that in the control group[( 10%( 8/80) vs. 16. 3%( 14/86) ],but there was no significant difference( P > 0. 05). The clinical pregnancy rate of the patients who had pregnancy requirements in the control group was higher than that in the control group [93. 75%( 30/32)vs. 70%( 14/20),P < 0. 05]. Conclusion Medical polyethylene glycol berberine can promote the pregnancy rate. Meanwhile,the operation is simple and has higher compliance rate,which is an effective way in improving clinical outcomes.
Objective To explore the effect of medical polyethylene glycol berberine on clinical outcomes after curettage. Methods A total of 166 curettage patients were divided into study group( n = 80) and control group( n = 86) by the patients' willingness. The two groups were given routine curettage,and the study group were additionally given 3 mL medical polyethylene glycol berberine by uterine cavity injection,while the control group infused no drugs. The postoperative endometrial thickness,menstruation situation were compared,and the re-pregnancy conditions of the patients in control group( n = 20) and experimental group( n = 32) with two-child requirement at follow-up and in one and a half year after follow-up were compared. Results The endometrial thickness in the study group was thicker than that in the control group [( 9. 44 ± 1. 95) mm vs.( 8. 65 ± 2. 28) mm,P < 0. 05],the proportion of the endometrial thickness < 8 mm in the study group was lower than that in the control group[27. 5%( 22/80) vs. 38. 4%( 33/8),P < 0. 01]. The ratio of patients with eumenorrhea was lower than that in the control group[( 10%( 8/80) vs. 16. 3%( 14/86) ],but there was no significant difference( P > 0. 05). The clinical pregnancy rate of the patients who had pregnancy requirements in the control group was higher than that in the control group [93. 75%( 30/32)vs. 70%( 14/20),P < 0. 05]. Conclusion Medical polyethylene glycol berberine can promote the pregnancy rate. Meanwhile,the operation is simple and has higher compliance rate,which is an effective way in improving clinical outcomes.
引文
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[7]李娜,朱久新,张妍,等.医用聚乙二醇小檗碱液对大鼠腹部术后肠黏连的预防作用[J].哈尔滨医科大学学报,2016,50(5):430-433.
[8] Adoni A,Palti Z,Milwidsky A,et al. The incidence of intrauterine adhesions following spontaneous abortion[J]. Int J Fertil,1982,27(2):117-118.
[9] Westendorp I C,Ankum W M,Mol B W,et al. Prevalence of Asherman'syndrome after secondary removal of placental remnants or a repeat curettage for incomplete abortion[J].Hum Reprod,1998,13(12):3347-3350.
[10] Friedler S,Margalioth E J,Kafka I,et al. Incidence of postabortion intra-uterine adhesions evaluated by hysteroscopy:a prospective study[J]. Hum Reprod,1993,8(3):442-444.
[11] Buttram V C Jr,Turati G. Uterine synechiae:variations in severity and some conditions which may be conducive to severe adhesions[J]. Int J Fertil,1977,22(2):98-103.
[12] Yu D,Wong Y M,Cheong Y,et al. Asherman syndrome:one century later[J]. Fertility and Sterility,2008,89(4):759-779.
[13] Conforti A,Alviggi C,Mollo A,et al. The management of Asherman syndrome:a review of literature[J]. Reprod Biol Endocrinol,2013,118:1-11.
[14] Chen Y Q,Chang Y J,Yao S Z. Role of angiogenesis in endometrial repair of patients with severe intrauterine adhesion[J]. Int J Clin Exp Pathol,2013,6(7):1343-1350.
[15] Lin N C,Li X N,Song T R,et al. The effect of collagenbinding vascular endothelial growth factor on the remodeling of scarred rat uterus following full-thickness injury[J]. Biomaterials,2012,33(6):1801-1807.
[2]张运辉,陈婵玉.无痛人工流产术后宫颈和宫腔粘连发生比例分析[J].中国生育健康杂志,2010,21(1):37-38.
[3] Salzani A,Yela D A,Gabiatti J R E,et al. Prevalence of uterine synechia after abortion evacuation curettage[J]. Sao Paulo Med J,2007,125(5):261-264.
[4]徐洁,林丹.宫腔粘连的研究进展[J].中国计划生育和妇产科,2017,9(8):18-20.
[5]季晓媛,凌秀凤.宫腔粘连的研究进展[J].中国妇幼健康研究,2015,26(5):1097-1099.
[6] Fuchs N,Smorgick N,Ben Ami I,et al. Intercoat(Oxiplex/AP gel)for preventing intrauterine adhesions after operative hysteroscopy for suspected retained products of conception:double-blind,prospective,randomized pilot study[J]. Journal of Minimally Invasive Gynecology,2014,21(1):126-130.
[7]李娜,朱久新,张妍,等.医用聚乙二醇小檗碱液对大鼠腹部术后肠黏连的预防作用[J].哈尔滨医科大学学报,2016,50(5):430-433.
[8] Adoni A,Palti Z,Milwidsky A,et al. The incidence of intrauterine adhesions following spontaneous abortion[J]. Int J Fertil,1982,27(2):117-118.
[9] Westendorp I C,Ankum W M,Mol B W,et al. Prevalence of Asherman'syndrome after secondary removal of placental remnants or a repeat curettage for incomplete abortion[J].Hum Reprod,1998,13(12):3347-3350.
[10] Friedler S,Margalioth E J,Kafka I,et al. Incidence of postabortion intra-uterine adhesions evaluated by hysteroscopy:a prospective study[J]. Hum Reprod,1993,8(3):442-444.
[11] Buttram V C Jr,Turati G. Uterine synechiae:variations in severity and some conditions which may be conducive to severe adhesions[J]. Int J Fertil,1977,22(2):98-103.
[12] Yu D,Wong Y M,Cheong Y,et al. Asherman syndrome:one century later[J]. Fertility and Sterility,2008,89(4):759-779.
[13] Conforti A,Alviggi C,Mollo A,et al. The management of Asherman syndrome:a review of literature[J]. Reprod Biol Endocrinol,2013,118:1-11.
[14] Chen Y Q,Chang Y J,Yao S Z. Role of angiogenesis in endometrial repair of patients with severe intrauterine adhesion[J]. Int J Clin Exp Pathol,2013,6(7):1343-1350.
[15] Lin N C,Li X N,Song T R,et al. The effect of collagenbinding vascular endothelial growth factor on the remodeling of scarred rat uterus following full-thickness injury[J]. Biomaterials,2012,33(6):1801-1807.
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