宫腔镜电切手术在胚胎残留患者中的疗效观察及对VEGF、FGF血管生成因子的影响

Observation of the curative effect of hysteroscopic electric resection in patients with residual embryos and its influence on VEGF and FGF angiogenesis factors

目的探讨宫腔镜电切手术在胚胎残留患者中的疗效观察及对血清血管内皮生长因子(VEGF)、成纤维细胞生长因子(FGF)的影响研究。方法选择2017年1月至2020年1月广东省四会市妇幼保健院妇产科胚胎残留患者128例,随机分为对照组(n=64例)和观察组(n=64例)。对照组给予清宫手术治疗,观察组给予宫腔镜电切手术治疗,治疗7 d后对患者效果进行评估,比较两组血清VEGF、FGF水平、外周血CD3+T细胞、手术指标以及术后并发症。结果观察组治疗后1周血清VEGF水平、FGF水平均低于对照组,差异有统计学意义(P<0.05);观察组患者的CXCR1和CCR2均低于对照组,细胞CCR6和CCR5均高于对照组,差异有统计学意义(P<0.05);观察组患者的手术时间无明显区别,而术中出血量、术后下床时间、术后出血时间均低于对照组,差异有统计学意义(P<0.05);观察组患者术后腹痛、清除不彻底、子宫粘连、子宫穿孔的并发症发生率(6.24%),明显低于对照组并发症发生率(17.18%)差异有统计学意义(P<0.05)。结论宫腔镜电切手术用于胚胎残留患者中能降低VEGF、FGF水平,不良反应发生率较低,手术创伤较小,能降低血管生成因子水平,值得推广应用。

Objective To investigate the effect of hysteroscopic resection in patients with residual embryos and the study of its effect on serum vascular endothelial growth factor(VEGF)and fibroblast growth factor(FGF).Methods From January 2017 to January 2020,128 patients with residual embryos in the Department of Obstetrics and Gynecology,Maternal and Child Health Hospital of Sihui City,Guangdong Province were randomly divided into a control group(n=64 cases)and an observation group(n=64 cases).The control group was treated with uterine evacuation surgery,and the observation group was treated with hysteroscopic resection.After 7 days of treatment,the patient.s effect was evaluated,and the two groups were compared with serum VEGF,FGF levels,peripheral blood CD3+T cells,surgical indicators,and postoperative complications.Results The serum VEGF and FGF levels of the observation group were lower than those of the control group one week after treatment,and the difference was statistically significant(P<0.05).The CXCR1 and CCR2 in the observation group were lower than those of the control group,and the cell CCR6 and CCR5 were higher than those in the control group,the difference was statistically significant(P<0.05).There was no significant difference in the operation time of patients in the observation group,but intraoperative blood loss,postoperative time to get out of bed,and postoperative bleeding time were lower than those of the control group,and the difference was statistically significant(P<0.05).The complication rate of postoperative abdominal pain,incomplete removal,uterine adhesion,and uterine perforation in the observation group(6.24%)was significantly lower than that in the control group(17.18%).The difference is statistically significant(P<0.05).Conclusion Hysteroscopic electric resection can reduce the levels of VEGF and FGF in patients with residual embryos.It has a lower incidence of adverse reactions and less surgical trauma,and can reduce the level of angiogenic factors.It is worthy of popularization and application.