邓丽娜,吴东波,李毅,王冬莲
DENG Lina,WU Dongbo,LI Yi,WANG Donglian

• 1:长沙市第一医院妇科
• 2:湖南省妇幼保健院妇科

摘要(Abstract)：

目的:探讨透明质酸钠凝胶联合芬吗通口服预防高危人流患者术后宫腔粘连(IUA)的效果及对血清白细胞介素10(IL-10)及IL-18水平的影响。方法:224例高危人流术患者随机均分为对照组和观察组,对照组患者术后给予常规中成药预防感染、益母草缩宫治疗,观察组患者在对照组治疗的基础上给予芬吗通口服及透明质酸钠凝胶宫腔内注射;术后随访3月,比较2组患者IUA发生率及粘连程度,于治疗前和治疗结束时采集2组患者清晨空腹静脉血,采用酶联免疫法检测血清IL-10、IL-18水平;采用MVIS-2035自动流变分析仪测定全血黏度及血浆黏度,记录2组患者治疗期间的不良反应。结果:治疗后,观察组出现IUA患者比例,发生轻度、中度、重度粘连的患者比例低于对照组(P<0.05);治疗前,2组患者血清IL-10、IL-18水平、全血黏度及血浆黏度比较,差异无有统计学意义(P>0.05);治疗结束时,2组患者血清IL-10水平较治疗前升高、IL-18水平、全血黏度及血浆黏度较治疗前降低,观察组前3组指标变化更显著(P<0.05);治疗期间,两组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论:透明质酸凝胶联合芬吗通口服可以有效预防高危人流术后宫腔粘连的发生及降低宫腔粘连的程度,可能通过影响IL-10和IL-18的水平有关。
Objective: To observe the serum level of interleukin10( IL10) and interleukin18( IL18)in intrauterine adhesion( IUA) caused by high-risk abortion operation and the effect of sodium hyaluronate gel combined with Femoston for the prevention of IUA. Method: 224 patients with high-risk abortion were randomly divided into the control group and the observation group. The control group was given conventional therapy,while the observation group was treated with intrauterine injection of sodium hyaluronate gel combined with oral Femoston based on the treatment for the control group. The incidence,severity and serum level of IL10 and IL18 of both groups were observed,and the safety of Femoston was evaluated. Results: The incidence and the degree of IUA in the observation group were significantly lower than those in the control group( P < 0. 05). Before treatment,The difference of the serum IL-10 level and IL-18 level between the two groups was not statistically significant( P > 0. 05).After treatment,the serum IL-10 level of the observation group increased,higher than that of the control group( P < 0. 05); the serum IL-18 level of the observation group was lower than that before treatment,and lower than that of the control group( P < 0. 05). The blood viscosity and plasma viscosity of the observation group were not statistically different from those of the control group before treatment( P> 0. 05). After treatment,the whole blood viscosity and plasma viscosity of the observation group were all lower than those of the control group( P < 0. 05),and the difference was not statistically significant. Conclusions: Hyaluronic acid gel combined with oral Fenton can effectively prevent the occurrence of IUA and reduce the degree of IUA after high-risk abortion operation. It may influence the level of IL-18 and IL-18,and is worthy of clinical promotion.

关键词(KeyWords)： 宫腔粘连;人流术;白介细胞素10;白介细胞素18;透明质酸钠凝胶;芬吗通;预防;效果
intrauterine adhesion;abortion operation;interleukin-10;interleukin-18;sodium hyaluronate gel;femoston;prevention;curative effect

Abstract:

Keywords:

基金项目(Foundation): 湖南省科技厅计划项目(2009SK3052)

作者(Author): 邓丽娜,吴东波,李毅,王冬莲
DENG Lina,WU Dongbo,LI Yi,WANG Donglian

DOI: 10.19367/j.cnki.1000-2707.2018.08.021

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