Objective To assess different treatment modality for intrauterine adhesion(IUA) fol owing hysteroscopic adhe-siolysis. Methods A total of 212 patients with intrauterine adhesion (≥grade II) were assigned into two groups: in group A (n=128) patients were treated with insertion of an intrauterine contraception device(IUD) and in group B(n=84) Foley bal oon com-bined with IUD was used. The postoperative treatment was the same for both groups. Patients were assessed per 28 days after operation. After 3 cycles of hormone therapy the intrauterine devices were removed, the second-look surgery by hysteroscope was performed and menstruation records were obtained. Results There were no significant differences in menstrual recovery in the equal grades of two groups, who showed hypomenorrhea before surgery (P>0.05). While there were 93.8% of women in grade IV of group B, who had amenorrhea pre-surgery, resumed menses compared with group A of the same grade(62.5%)(P<0.05). Total y 103 Amenorrhea patients pre-surgery received adhesiolysis, in whom 92 cases resumed menses (89.3%). IUD in-carceration occurred in 12 patients (5.7%), including 8 in group A and 4 in group B (P>0.05). IUA was reformed in 110 patients (51.9%), the incidence of reformation in group A of degree IV was higher than that in group B of the same degree (P<0.05). Conclusion Adopting the Foley bal oon combined with IUD has a better clinical effect than IUD only as ancil ary treatment after adhesionlysis in grade IV of IUA patients.% 目的探讨Ⅱ度以上宫腔粘连分离术采用不同物理屏障抗粘连的临床效果。方法选取212例Ⅱ度以上宫腔粘连患者，其中宫腔粘连分离术留置宫内节育器者作为A组（Ⅱ度47例，Ⅲ度38例，Ⅳ度43例），宫腔粘连分离术留置宫内球囊后改放置节育器者作为B组（Ⅱ度28例，Ⅲ度30例，Ⅳ度26例）。以上两组术后其他后续治疗方法均一致。术后每28d复查1次，性激素序贯治疗3周期结束后予以宫腔镜下节育器取出术同时行二次探查并登记月经情况。结果（1）月经情况：两组术前月经过少的同度患者相比，月经恢复情况差异无统计学意义（P＞0.05）。术前闭经患者术后月经复潮率89.3%（92/103）。IV度术后月经复潮率B组高于A组，差异有统计学意义（93.8%vs 62.5%，P＜0.05）。（2）并发症发生率及预后情况：宫内节育器嵌顿共12例，A组8例，B组4例，总发生率5.7%，两组之间差异无统计学意义（P＞0.05）。未发现泌尿道生殖道感染病例。宫腔粘连重新形成110例（51.9%）；其中IV度A组高于B组，差异有统计学意义（P＜0.05）。结论对于IV度宫腔粘连行宫腔镜下分离术，术中留置宫内球囊后改宫内节育器将比单独使用宫内节育器有更好的治疗效果。
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