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目的:评价宫内放置防粘连膜(Interceed)在预防中重度宫腔粘连术后再粘连中的疗效。方法:收集2015年6月至2016年6月于郑州大学第二附属医院经宫腔镜检查诊断为中重度宫腔粘连并成功手术分离粘连的72例患者,随机分成2组,A组40例为Interceed组(TCRA宫腔粘连分离术术后宫内放置防粘连膜预防粘连),B组32例为几丁糖组(TCRA宫腔粘连分离术术后宫内灌注医用几丁糖3 m L预防粘连),2组均行TCRA+E2V+生长激素综合治疗。随访术后1个月、3个月2组宫腔再粘连情况及术后3个月子宫内膜生长情况。结果:Interceed组术后1个月总有效率(77.5%)及术后3个月总有效率(87.5%)均明显高于几丁糖组术后1个月总有效率(53.1%)及术后3个月总有效率(56.3%),差异具有统计学意义(P<0.05),Interceed组术后3个月内膜生长厚度[(6.38±2.70)mm]明显高于几丁糖组术后3个月内膜生长厚度[(4.97±1.60)mm],差异有统计学意义(P<0.05)。结论:Interceed有效预防中重度宫腔粘连术后宫腔再粘连的发生,临床价值高。
Objective: To evaluate the effect of intrauterine placement of anti-adhesion membrane (Interceed) in the prevention of re-adhesion after moderate-severe intrauterine adhesions. Methods: Seventy-two patients with moderate or severe intrauterine adhesions diagnosed as moderate-to-severe intrauterine adhesions and operative adhesions by Hysteroscopy at the Second Affiliated Hospital of Zhengzhou University from June 2015 to June 2016 were randomly divided into two groups, 40 cases in group A Interceed group (TCRA intrauterine adhesions separation intrauterine placement of anti-adhesion membrane to prevent adhesion), B group 32 cases of chitosan group (TCRA intrauterine adhesions intrauterine infusion of medical chitosan 3 m L Prevention of adhesions), 2 groups were TCRA + E2V + growth hormone comprehensive treatment. Follow-up 1 month after surgery, 3 months 2 cases of uterine cavity adhesions and 3 months after the endometrial growth. Results: The total effective rate (77.5%) at 1 month and the total effective rate at 3 months (87.5%) in Interceed group were significantly higher than those in Chitosan group (53.1%) at 1 month after operation The total effective rate at 3 months after operation was 56.3%, the difference was statistically significant (P <0.05). The thickness of intima of the 3-month post-operation in Interceed group [(6.38 ± 2.70) mm] was significantly higher than that of chitosan group The thickness of intima-media thickness within 3 months after operation was (4.97 ± 1.60) mm, the difference was statistically significant (P <0.05). Conclusion: Interceed is effective in preventing the occurrence of reoccavation of uterine cavity after moderate-severe uterine adhesions. It has high clinical value.