宫腔镜下金属弯钩分离术联合激素治疗宫腔粘连的效果观察

Effects of hysteroscopic metal hook separation combined with hormones on patients with intrauterine adhesion

目的探讨宫腔镜下金属弯钩分离术联合激素治疗宫腔粘连(IUA)的效果。方法抽取2018年2月至2020年2月在驻马店市中心医院就诊的IUA患者106例,按随机数表法分为观察组(53例)和对照组(53例)。两组患者均接受宫腔镜下金属弯钩分离术治疗,在此基础上,对照组术后口服戊酸雌二醇3 mg/次,观察组术后口服戊酸雌二醇6 mg/次,比较两组患者的雌激素受体(ER)表达水平、子宫恢复情况、子宫内膜功能和月经恢复情况。结果治疗后,观察组ER-α、ER-β蛋白表达水平低于对照组,子宫内膜厚度、子宫体积大于对照组(P<0.05);治疗后,观察组的转化生长因子-β(TGF-β)、Smad3蛋白表达水平低于对照组,干扰素-γ(IFN-γ)表达水平高于对照组(P<0.05);治疗后观察组患者的月经量大于对照组,月经恢复时间短于对照组(P<0.05)。结论宫腔镜下金属弯钩分离术联合激素在治疗IUA方面疗效确切,且术后大剂量激素的使用能进一步降低子宫内膜ER的表达水平,促进宫腔形态、子宫功能及月经的恢复。

Objective To explore the curative effect of hysteroscopic metal hook separation combined with hormones on intrauterine adhesion(IUA).Methods A total of 106 IUA patients admitted to Zhumadian Central Hospital from February 2018 to February 2020 were selected,they were divided into observation group(53 cases)and control group(53 cases)by random number table method.Both groups underwent hysteroscopic metal hook separation.On this basis,control group was given oral estradiol valerate(3 mg each time),while observation group was given oral estradiol valerate(6 mg each time)after surgery.The expression level of estrogen receptor(ER),uterine recovery,endometrial function and menstrual recovery were compared between the two groups.Results After treatment,expression levels of ER-αand ER-βproteins in observation group were lower than those in control group,while endometrial thickness and uterine volume were larger than those in control group(P<0.05).After treatment,expression levels of transforming growth factor-β(TGF-β)and Smad3 protein in observation group were lower than those in control group,while expression level of interferon-γ(IFN-γ)was higher than that in control group(P<0.05).After treatment,menstrual volume in observation group was more than that in control group,while menstrual recovery time was shorter than that in control group(P<0.05).Conclusions The curative effect of hysteroscopic metal hook separation combined with hormones is significant on IUA.The high-dose hormones can further reduce expression level of endometrial ER,and promote the recovery of uterine cavity morphology,uterine function and menstruation.