宫腔灌注自体PBMCs结合低分子肝素助孕治疗宫腔粘连分离术后患者的临床疗效

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目的:探讨宫腔灌注自体外周血单个核细胞(PBMCs)结合低分子肝素助孕治疗宫腔粘连分离术后患者的临床疗效。方法:9例宫腔粘连分离术后患者在移植前48 h进行宫腔灌注自体PBMCs,移植日始结合每日皮下注射低分子肝素3 200 IU,测量子宫内膜厚度并观察妊娠结局。结果:9例患者在宫腔灌注自体PBMCs后,发现宫内膜厚度增加,其中6例宫内膜形态较前有改善;移植后7例患者临床妊娠,1例患者生化妊娠,1例患者未妊娠;7例临床妊娠中有1例患者为宫内外复合妊娠(已进行患侧输卵管妊娠手术),另有2例患者在妊娠第7~8周B超提示胚胎停育;9例患者中4例反复种植失败患者有3例临床妊娠。目前本组患者中2例已活产,另3例正常持续妊娠中,9例患者均未发生感染、出血、血小板减少和过敏反应等不良事件。结论:宫腔灌注人自体PBMCs结合低分子肝素有益于子宫内膜容受性的提高,可改善部分宫腔粘连分离术后患者的助孕结局。“,”Objective:To investigate the assisted pregnancy clinical effect of autologous peripheral blood mononuclear cells (PBMCs) combined with low molecular weight heparin (LMWH) on patients with intrauterine adhesion separation.Methods:Nine patients with intrauterine adhesion separation were treated with intrauterine perfusion of PBMCs 48 hours before transplantation. The low molecular weight heparin 3 200 IU injected daily subcutaneously were carried out on the day of transplantation. Measurement of endometrial thickness and observation of pregnant outcome were perfomed.Results:After 9 patients were injected into the uterine cavity with autologous PBMCs. It was found that, compared to the previous, the thickness of the endometrium was increased, and the morphology of the endometrium was improved in 6 cases. After transplantation, 7 cases of the patients were clinically pregnant, 1 of the patients was biochemically pregnant, and 1 of the patients was not pregnant; among the 7 clinical pregnancy cases, 1 case was intrauterine compound pregnancy (operation on the affected side of fallopian tube pregnancy had been performed), another 2 cases had embryo termination at the 7-8th week of gestation by B-scan ultrasonography analysis. However, 3 cases of clinical pregnancy in 4 patients with repeated implantation failure. At present, 2 cases were in live labor, and the other three cases were in normal continuous pregnancy.Conclusions:Intrauterine perfusion of human PBMCs combined with low molecular weight heparin is beneficial to the improvement of endometrial receptivity and the pregnancy outcome of some patients after the separation of intrauterine adhesions.
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