宫腔粘连分离术后预防再粘连的研究进展
Research Progress on Preventing Readhesion after Intrauterine Adhesion Separation Surgery

宫腔粘连(intrauterine adhesions, IUA)是子宫内膜基底层因创伤或感染所引起的宫腔、宫颈管不同程度粘连、闭塞，可表现为月经量减少、闭经、不孕、痛经、反复流产等临床症状，是妇科常见的严重危害生育功能。宫腔镜下粘连分离术(TCRA)是IUA手术治疗的标准术式。目前临床中常采用物理屏障或生物屏障材料隔离联合药物或生物制剂治疗预防术后再粘连。中医药常用的治疗方法包括以补肾活血为主的内治法，以针灸、中药灌肠、中药热敷为主的外治法。上述治疗方法对于预防TCRA后再粘连，增加月经量，改善子宫内膜容受性，提高妊娠率，降低流产率等方面均显示了较好的疗效，值得临床进一步研究和推广应用。
Intrauterine adhesions (IUA) are clinical symptoms of reduced menstrual flow, amenorrhea, infertility, dysmenorrhea, and recurrent miscarriage caused by varying degrees of adhesion and occlusion of the uterine cavity and cervical canal in the basal layer of the endometrium due to trauma or infection. They are a common and serious threat to reproductive function in gynecology. Hysteroscopic adhesiolysis (TCRA) is the standard surgical procedure for the treatment of intrauterine adhesions (IUA). At present, physical barriers or biological barrier materials are commonly used in clinical practice to isolate and prevent postoperative adhesions by combining medication or biological agents. The commonly used treatment methods of traditional Chinese medicine include the internal treatment based on tonifying the kidney and activating blood circulation, and the external treatment based on acupuncture and moxibustion, traditional Chinese medicine enema, and traditional Chinese medicine hot compress. The above treatment methods have shown good efficacy in preventing re adhesion after TCRA, increasing menstrual flow, improving endometrial receptivity, increasing pregnancy rate, and reducing miscarriage rate, and are worthy of further clinical research and promotion.