Objective: To evaluate the impact of self-crosslinked hyaluronic acid (SCH) gel on endometrium recovery after artificial abortion. Methods: A multicenter, prospective randomized controlled trial was conducted across 18 hospitals from December 2021 to February 2023, involving 382 women who underwent artificial abortion. Participants were randomly allocated to receive either treatment with SCH gel (SCH group) or no treatment (control group) in a 1∶1 ratio. The primary outcome was endometrium thickness in 14 to 18 days after the first postoperative menstruation. Secondary outcomes included changes in menstrual volume during the first postoperative menstruation, menstruation resumption within 6 postoperative weeks, time to menstruation resumption, duration of the first postoperative menstruation, and incidence of dysmenorrhea. Results: Baseline characteristics of participants were comparable between the two groups (all P>0.05), with 95.3% (182/191) in SCH group and 92.7% (177/191) in the control group completed the study. The postoperative endometrial thickness in SCH group was significantly greater than that in the control group [(9.78±3.15) vs (8.95±2.32) mm; P=0.005]. SCH group also had significantly fewer participants with reduced menstrual volume [23 cases (12.6%, 23/182) vs 31 cases (17.5%, 31/177); P=0.038]. Although SCH group experienced less dysmenorrhea during the first postoperative menstrual period, this difference was not statistically significant [28.5% (51/179) vs 37.1% (65/175); P=0.083]. Outcomes were similar between SCH group and the control group regarding the proportion of participants who resumed menstruation within 6 weeks postoperatively, time to menstruation resumption, and duration of the first postoperative menstruation (P=0.792, 0.485, and 0.254, respectively). No serious adverse events were observed during the study period, and no adverse events were attributed to SCH gel treatment. Conclusion: The application of SCH gel after artificial abortion is safe and might aid in the recovery of the endometrium.
目的： 评估人工流产手术后应用自交联透明质酸钠（SCH）凝胶对子宫内膜修复的影响。 方法： 本研究为多中心、前瞻性随机对照试验。纳入2021年12月至2023年2月期间18家医院的382例接受人工流产手术的妇女。以交叉设计随机化生成分配表并制作随机分配信封，全部受试者按照随机信封以1∶1比例分配至SCH组（接受SCH凝胶治疗）、对照组（未接受SCH凝胶治疗），均为191例。主要疗效指标为术后首次月经结束后第14~18天的子宫内膜厚度，次要疗效指标包括术后6周内是否月经复潮、月经复潮时间、术后首次月经的经量变化（与术前比较）、术后首次月经经期天数以及痛经情况。 结果： 两组受试者的基线特征差异均无统计学意义（P均>0.05）；382例受试者中，共有359例［SCH组182例（95.3%，182/191）、对照组177例（92.7%，177/191）］完成了本研究的统计学分析。SCH组受试者人工流产手术后子宫内膜厚度显著大于对照组［分别为（9.78±3.15）、（8.95±2.32）mm；P=0.005］。SCH组经量减少的发生率也明显低于对照组［分别为12.6%（23/182）、17.5%（31/177）；P=0.038］。尽管SCH组术后首个月经期间痛经情况较少，但两组比较，差异无统计学意义［分别为28.5%（51/179）、37.1%（65/175）；P=0.083］。在术后6周内月经复潮的例数、月经复潮时间和经期天数方面，两组之间分别比较均无显著差异（P均>0.05）。研究期间未观察到严重不良事件，且无任何归因于SCH凝胶治疗的不良事件。 结论： 人工流产手术后应用SCH凝胶是安全的，并有助于促进子宫内膜的修复。.