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目的:评价应用不同剂量戊酸雌二醇对宫腔粘连切除术(TCRA)后辅以人工周期疗效的影响。方法:选择临床确诊为宫腔粘连(IUA)的患者230例,行TCRA后,先放置球囊引流再放置宫内节育器(IUD),并随机分为A组和B组,A组给予戊酸雌二醇(E2)3 mg/d(n=128),B组9 mg/d(n=102),所有患者均联合孕激素口服行人工周期治疗,上述术后治疗连用3个周期。定期随访药物反应及月经改善情况,3个月后B超及宫腔镜检查了解术后子宫内膜厚度及宫腔情况,评价临床疗效。结果:TCRA后辅以人工周期治疗,IUA患者子宫内膜较术前增厚,差异有统计学意义(P<0.05);B组患者较A组患者更明显,组间差异有统计学意义(P<0.05)。TCRA后B组行人工周期的临床疗效优于A组,治愈率及有效率均高于A组(P<0.05)。结论:TCRA后联合人工周期治疗,能促进IUA患者术后受损子宫内膜增生,且B组优于A组;B组较A组的临床疗效更好,且是安全的。
Objective: To evaluate the effects of different doses of estradiol valerate on the efficacy of artificial period after esophageal resection (TCRA). Methods: Totally 230 patients with clinically diagnosed intrauterine adhesions (IUA) were enrolled in this study. After TCRA, IUD was placed by balloon drainage and then randomly divided into A group and B group. All patients were treated with oral administration of progesterone orally in combination with 3 cycles of oral administration of estradiol (E2) 3 mg / d (n = 128) and group B of 9 mg / d (n = 102). Regular follow-up of drug response and improvement of menstruation, 3 months after B-ultrasound and hysteroscopy to understand postoperative endometrial thickness and uterine cavity situation, evaluate the clinical efficacy. Results: TCRA followed by artificial cycle treatment, IUA endometrial thickening compared with preoperative, the difference was statistically significant (P <0.05); B group patients were more obvious than the A group, the difference between the two groups was statistically significant ( P <0.05). After TCRA, the clinical efficacy of artificial cycle in group B was better than that in group A, and the cure rate and effective rate were higher than those in group A (P <0.05). Conclusion: TCRA combined with artificial cycle treatment can promote IUA patients with postoperative impaired endometrial hyperplasia, and group B is better than group A; group B is better than group A clinical efficacy, and is safe.