Absorbable biomedical membrane-embedded intrauterine device in prevention of recurrence after hysteroscopic adhesiolysis for severe intrauterine adhesion / 中华全科医师杂志

Objective To assess the effects of absorbable biomedical membrane-embedded intrauterine device ( IUD) in prevention of recurrence after hysteroscopic adhesiolysis for severe intrauterine adhesions ( IUA ) .Methods A prospective study was carried out among 125 patients who underwent hysteroscopic adhesiolysis for severe IUA from February 2013 to January 2015.Foley catheter was placed immediately after surgery and removed 7 days later.Then patients were randomly divided into three groups:group A (40 cases) received round IUD insertion after catheter removal;froup B (41 cases) received IUD placement and intrauterine injection of sodium hyaluronate; group C ( 44 cases ) received absorbable biomedical membrane-embedded IUD insertion.All patients received two artificial cycles ( oral estradiol valerate, 9 mg/d) the first day after surgery.Hysteroscopy was carried out two months later to assess the repair of endometrium.Patients who were cured or whose condition was greatly improved received three-dimensional transvaginal ultrasound examination in the first natural cycle.Thickness of endometrium, uterine volume and blood flow index were compared.Results Cure rate and effective rate in group C were significantly higher than that in groups B and A [43%(19/44) vs.22%(9/41) and 20%(8/40), χ2 =6.89,P=0.03, 86%(37/44) vs.56%(26/41) and 65%(23/40), χ2 =9.78, P =0.01].The improvement rate of menstruation was higher in group C compared with groups B and A [84%(37/44) vs. 63%(26/41)and 58%(23/40),χ2 =7.73, P=0.02].Average endometrium thickness, uterine volume and blood flow index were also significantly improved in Group C[(8.4 ±1.1) vs.(7.2 ±1.5) and (7.6 ± 1.1) mm, F=5.42,P=0.01,(4.3 ±0.3) vs.(3.9 ±0.4) and (4.0 ±0.6) cm3 ,F=7.12,P=0.00, 28.0 ±4.0 vs.24.6 ±4.7 and 23.4 ±4.0,F =5.40,P =0.01] .No significantly differences were observed between group B and group A in terms of the above indices.Conclusion Insertion of absorbable biomedical membrane embedded-IUD has a good therapeutic effect and can better prevent adhesion recurrence in patients with severe intrauterine adhesion after adhesiolysis.

Nursing for patients who had accepted testicular sperm extraction / 中国实用护理杂志

Objective In order to know the nursing points for patients with obstructive azoospermia when cured by testicular sperm extraction combined with intracytoplasmic sperm injection. Methods Summurized the nursing pionts from nine patients with obstructive azoospermia when cured by testicular sperm extraction combined with intracytoplasmic sperm injection. The main nursing cares inclued peri-operative nursing points, psychological nursing and fellow up. Results All the nine patients had TESE successful and enter the ICSI period without any complication. There was a newborn had deliver-ied successfully. Conclusions Positive psychological nursing, careful perioperative nursing cares and counter preventive measures are the guarantee for smoothly operation and postoperative rehabilitation.