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目的比较雌激素给药途径对宫腔重度粘连术后预防再粘连的影响。方法选取2015年1月-2016年5月在郑州大学第三附属医院就诊的且完成随访的60例宫腔重度粘连患者为研究对象,随机分为A、B两组,每组各30例。A组给予阴塞芬吗通1 mg/d,B组口服补佳乐4 mg/d,21 d为1个周期,后5 d加服黄体酮胶囊100 mg/d;应用2个人工周期后,在月经干净3~7 d复查宫腔镜;比较术后雌激素体内血药浓度、内膜恢复情况、月经改善率、宫腔恢复率和不良反应发生率。结果治疗后,A组体内雌激素血药浓度高于B组,两组比较,差异有统计学意义(P<0.05);两组在应用第二个人工周期后,A组的子宫内膜平均厚度高于第一人工周期,但A组和B组之间子宫内膜厚度比较,差异无统计学意义(P>0.05);两组月经改善情况、宫腔恢复情况和不良反应发生情况比较,差异无统计学意义(均P>0.05)。结论不同给药途径的雌激素血药浓度具有显著差异;宫腔重度粘连术后的预后与雌激素血药浓度无依赖性;口服途径及阴塞途径的雌激素对于宫腔重度粘连的预后没有明显差异。
Objective To compare the effect of estrogen administration on the prevention of reunion after intrauterine adhesion. Methods From January 2015 to May 2016, 60 patients with severe intrauterine adhesions treated in the Third Affiliated Hospital of Zhengzhou University were enrolled and randomly divided into A and B groups, 30 cases in each group. The patients in group A were given 1 mg / d of salbutamol, the patients in group B received oral gavage 4 mg / d for 21 days, and the other group received progesterone 100 mg / d 5 days later. After 2 artificial cycles , Hysteroscopy was performed after the menstruation was clean for 3 to 7 days. The plasma concentration of estrogen, the recovery of endometrium, the improvement rate of menstruation, the recovery rate of uterine cavity and the incidence of adverse reactions were compared between the two groups. Results After treatment, the plasma estrogen concentration of group A was higher than that of group B, the difference was statistically significant (P <0.05). After the second artificial cycle was applied, the mean endometrial thickness of group A The thickness was higher than the first artificial cycle, but there was no significant difference in the thickness of endometrium between group A and group B (P> 0.05). The improvement of menstruation, the recovery of uterine cavity and the occurrence of adverse reactions were compared between the two groups, The difference was not statistically significant (all P> 0.05). CONCLUSIONS: The estrogen concentrations in different administration routes are significantly different. The prognosis of intrauterine adhesion after esophagectomy is independent of estrogen plasma concentration. The oral and vaginal routes of estrogen have no effect on the prognosis of severe intrauterine adhesions Significant differences.