Intrauterine adhesions are a disease that affects the growth of the endometrium. This disease is mainly caused by chronic inflammation. Since the fertilized egg is not easy to implant, severe cases will affect reproductive function, so active treatment is required. This disease is best treated with a combination of Chinese and Western medicine. Patients should pay attention to rest, avoid catching cold, avoid eating spicy food, and also have a good attitude. Hysteroscopy is currently an effective means of treating intrauterine adhesions and is also the gold standard for diagnosis. It is a invasive surgery that reduces complications. Complications during hysteroscopy may include perforation, bleeding, shock, and even death. The surgery requires evaluation of the thickness, type, and blood flow of the endometrium, and assessment of the entire length of the cervical canal, internal cervical os, uterine cavity, and fallopian tubes. If necessary, perform laparoscopic curettage. 1. Hysteroscopic treatment Mild membranous adhesions can be bluntly separated (pushed, pushed, and peeled) with the tip of the hysteroscope; dense adhesions can be separated with micro scissors, forceps, needle electrode electroresection or laser surgery; severe adhesions: because perforation and bleeding are prone to occur at the edges or fibromuscular adhesions, they are often performed under laparoscopy or ultrasound monitoring. 2. Laparotomy Transabdominal hysterotomy for the treatment of intrauterine adhesions is rarely used now unless hysteroscopic separation is difficult. Prevention of intrauterine adhesions after surgery: Since intrauterine adhesions are prone to recurrence, especially severe ones, the recurrence rate can be as high as 62.5%, and repeated surgery and separation effect evaluation are often required. Therefore, preventing recurrence is the key to successful treatment. ① Placement of intrauterine device: Routine placement of intrauterine device after surgery is a widely used and effective method to prevent adhesions, and it is generally placed for at least 3 months. ② Placement of balloon catheter: The water-filled balloon acts as a barrier in the uterine cavity, effectively separating the front and back, upper and lower, and left and right side walls of the uterus, and effectively preventing re-adhesion of the uterine cavity. ③ Sodium hyaluronate: Sodium hyaluronate has a mechanical barrier effect and reduces the occurrence of intrauterine adhesions. ④ Medical chitosan and amniotic membrane transplantation. ⑤ Drugs: mainly continuous stimulation of endometrial growth such as estrogen-progesterone cyclical therapy, vasodilators, growth hormone, etc. |
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