Study on the Preventive Value of Aspirin Combined with Estradiol Valerate for Re-adhesion of Intrauterine Adhesions after TCRA

LI Ning; ZHANG Yan

doi:10.16458/j.cnki.1007-0893.2025.09.003

Abstract：Objective To explore the application effect of aspirin(ASA)combined with estradiol valerate(EV)in preventing re-adhesion after transcerivcal resection of adhesions(TCRA)of intrauterine adhesions.Methods A total of 102 patients with intrauterine adhesions who underwent TCRA treatment in the First Department of Gynecology of Kaifeng Obstetrics and Gynecology Hospital from January 2022 to January 2024 were selected as the research subjects.They were divided into an EV treatment group and an ASA+EV treatment group by random number table method,with 51 cases in each group.Patients in the EV treatment group received postoperative placement+EV treatment,while those in the ASA+EV treatment group received postoperative placement+ASA combined with EV treatment.The clinical efficacy,the recovery of menstrual cycle and endometrial thickness,the intrauterine blood flow,the recurrence of postoperative pregnancy and intrauterine adhesions,and the occurrence of adverse reactions of the two groups of patients were compared.Results The total effective rate of treatment in the ASA+EV treatment group(98.04%)was higher than that in the EV treatment group(80.39%),and the difference was statistically significant(P<0.05).Six months after the operation,the score of pictorial blood loss Assessment chart(PBAC)in the ASA+EV treatment group was higher than that in the EV treatment group,and the endometrial thickness was thicker than that in the EV treatment group,and the differences were statistically significant(P<0.05).At 3 months and 6 months after the operation,the resistance index(RI)and perfusion index(PI)of uterine artery blood flow in the ASA+EV treatment group were both lower than those in the EV treatment group,and the differences were statistically significant(P<0.05).The postoperative pregnancy rate of patients in the ASA+EV treatment group was higher than that in the ASA+EV treatment group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the recurrence rate of intrauterine adhesions and the total incidence of adverse reactions between the two groups(P>0.05).Conclusion The application of ASA combined with EV has a significant effect in preventing re-adhesion after TCRA for intrauterine adhesions.It can improve the blood supply to the patient's uterus,promote the repair and functional recovery of the endometrium,effectively increase the postoperative pregnancy rate of the patient,and at the same time will not increase the risk of recurrence and adverse reactions.