目的 探讨宫腔镜下宫腔粘连分离术（TCRA）后留置Foley球囊次数对重度宫腔粘连（IUA）患者再粘连的影响。 方法 对2022年1月至2025年1月在我院行TCRA的128例重度IUA患者的临床资料进行回顾性研究，根据其术后留置Foley球囊次数分为对照组（单次留置，n = 68）和观察组（两次留置，n = 60）。比较两组临床疗效、治疗前后IUA评分、月经变化、术后再粘连及妊娠情况。 结果 观察组总有效率90.00%（54/60），高于对照组的76.47%（52/68），差异有统计学意义（P < 0.05）。治疗后，观察组美国生育协会（AFS）评分（3.12 ± 1.06）分，低于对照组的（4.35 ± 1.21）分；IUA评分改善值（6.70 ± 1.57），高于对照组的（5.26 ± 1.62），差异有统计学意义（P < 0.05）。治疗后，观察组的月经量（40.22 ± 3.91）mL，高于对照组的（37.39 ± 4.10）mL；经期时间（5.06 ± 1.12）d，长于对照组的（4.41 ± 1.20）d，差异有统计学意义（P < 0.05）。两组再粘连发生率比较差异有统计学意义（15.00% vs. 32.35%，P > 0.05）。 结论 重度IUA患者TCRA术后两次留置Foley球囊可有效缓解IUA程度，提高月经量，改善经期，降低再粘连发生风险，值得临床研究。

Objective To investigate the effect of the frequency of Foley balloon placement after hysteroscopic transcervical resection of adhesion （TCRA） on re-adhesion in patients with severe intrauterine adhesions （IUA）. Methods The clinical data of 128 patients with severe IUA who underwent TCRA at the hospital from January 2022 to January 2025 were reviewed. According to the number of Foley balloon insertions after surgery， they were divided into a control group （single insertion， n = 68） and an observation group （two insertions， n = 60）. The clinical efficacy， IUA scores before and after treatment， menstrual changes， postoperative re-adhesion， and pregnancy status were compared between the two groups. Results The total effective rate reached 90.00% （54/60） in the observation group， which was higher than 76.47% （52/68） in the control group （P < 0.05）. After treatment， the American Fertility Society （AFS） Score of the observation group （3.12 ± 1.06） was lower than that of the control group （4.35 ± 1.21）. The improvement value of IUA score （6.70 ± 1.57） was higher than that of the control group （5.26 ± 1.62） （P < 0.05）. After treatment， menstrual blood volume of the observation group ［（40.22 ± 3.91） mL］ was larger than that of the control group ［（37.39 ± 4.10） mL］， and menstrual period ［（5.06 ± 1.12） d］ was longer than that of the control group ［（4.41 ± 1.20） d］ （P < 0.05）. There was a statistically significant difference in the incidence of re-adhesion between the two groups （15.00% vs. 32.35%， P > 0.05）. Conclusion The placement of Foley balloons twice after TCRA surgery in patients with severe IUA can effectively alleviate the degree of IUA， increase menstrual flow， improve menstruation， and reduce the risk of re adhesion. It is worthy of clinical research.