宫腔镜下能源电针分离与微型机械分离在治疗中、重度宫腔粘连中的疗效比较

Comparion of Efficacy between Hysteroscopic Energy Electroacupuncture Separation and Micro-hysteroscopic with Cold Loop in the Treatment of Moderate to Severe Intrauterine Adhesions

目的探讨宫腔镜下能源电针分离术与微型剪刀机械分离术治疗中、重度宫腔粘连的疗效。方法回顾性分析中、重度宫腔粘连患者76例,按手术方式分为两组,其中机械组36例,术中给予微型剪机械分离,能源组40例,给予等离子电针分离。比较两组术中手术时间、出血量、术后月经恢复情况、子宫内膜厚度及子宫腔形态、宫腔容积、术后妊娠情况。结果能源组20. 05±7. 30ml的术中出血明显少于机械组32. 30±13. 3ml,能源组14.75±3. 43min的手术时间明显少于机械组26.39±5. 39min(P <0.05)。能源组对宫腔形态恢复的满意率95%高于机械组83. 3%(P <0.05)。能源组月经恢复率95.0%高于机械组83. 3%(P <0.05)。能源组术后宫腔容积4.76±0.78ml高于机械组4.30±0.76ml(P <0.05),能源组术后子宫内膜厚度6. 35±1.30mm高于机械组5.18±1.76mm(P<0.05)。能源组妊娠率为57.5%高于机械组33.3%(P<0.05)。结论宫腔镜下能源电针分离术治疗中、重度宫腔粘连具有良好的疗果,值得临床推广。

Objective To investigate the efficacy of hysteroscopic energy electroacupuncture and hysteroscopic with cold loop of micro-scissors in the treatment of moderate to severe intrauterine adhesion. Methods A total of 76 patients diagnosed with severe intrauterine adhesions were divided into two groups according to the surgical method. Totally 36 cases of the energy group use the micro shear hysteroscopic with cold loop, while 40 cases of the mechanical group using plasma electroacupuncture separation. The operation time,blood loss, postmenstrual recovery, endometrial thickness and uterine cavity morphology, uterine volume, and postoperative pregnancy were compared between the two groups. Results The intraoperative bleeding in the energy group 20. 05 ± 7. 30 ml was significantly less than that in the mechanical group 32. 30 ± 13. 3 ml, and the operation time in the energy group 14. 75 ± 3.43 min was significantly less than that in the mechanical group 26. 39 ±5. 39 min(P <0. 05). The satisfaction rate of the energy group on morphological recovery(95%) was higher than that of the mechanical group 83. 3%(P <0.05). The menstrual recovery rate of the energy group(95%) was higher than that of the mechanical group 83. 3%,(P <0. 05). The uterine volume 4. 76 ±0. 78 ml in the energy group was higher than that in the mechanical group 4. 30 ±0. 76 ml(P <0. 05), and the endometrial thickness 6. 35 ± 1.30 mm in the energy group was higher than that in the mechanical group 5.18 ± 1.76 mm(P < 0. 05). The pregnancy rate of the energy group(57. 5%) was higher than that of the mechanical group 33. 3%(P< 0. 05). Conclusion Hysteroscopic energy electroacupuncture separation for the treatment of moderate to severe intrauterine adhesions has a good therapeutic effect and is worthy of clinical promotion.