两种宫腔镜冷刀治疗中重度宫腔粘连的临床效果观察

Observation on the clinical effects of two kinds of hysteroscopic cold knife on the treatment of moderate and severe intrauterine adhesions

目的观察两种宫腔镜冷刀治疗中、重度宫腔粘连的临床效果。方法回顾性分析使用宫腔镜下冷刀手术治疗的110例中重度宫腔粘连患者的临床资料。其中65例采用免扩宫宫腔镜冷刀系统(灵宝一体镜)行粘连分离术(观察组),45例采用HEOS宫腔镜冷刀粘连分离术(对照组),比较两组术中及术后相关指标。结果观察组手术时间短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05)。两组术后宫腔形态恢复情况差异无统计学意义(P>0.05)。观察组术后月经恢复情况优于对照组,差异有统计学意义(P<0.05)。观察组术后妊娠率高于对照组,差异有统计学意义(χ^(2)=8.486,P=0.004)。结论免扩宫一体镜宫腔镜系统治疗中重度宫腔粘连手术安全性高,相较于HEOS宫腔镜冷刀,具有手术时间短、出血量少、免扩宫、术后妊娠率高等优势。

Objective To observe the clinical effects of two kinds of hysteroscopic cold knife on the treatment of moderate and severe intrauterine adhesions.Methods A retrospective analysis was performed on 110 patients with moderate and severe intrauterine adhesions treated by cold-knife hysteroscopic surgery.The patients were divided into observation group and control group according to different treatment methods.The patients who underwent adhesion separation using non-dilatation cold-knife hysteroscopic system(Lingbao Integrated Mirror)were taken as the observation group(65 cases),while the patients who underwent adhesion separation using HEOS cold knife hysteroscopy were taken as the control group(45 cases).The intraoperative and postoperative related indicators were compared between the two groups.Results The operation time of the observation group was shorter than that of the control group,and the intraoperative blood loss in the observation group was less than that in the control group,and the differences were statistically significant between the two groups(P<0.05).There was no significant difference in the uterine shape recovery after surgery between the two groups(P>0.05).The postoperative recovery of menstruation in the observation group was better than that in the control group and the difference was statistically significant between the two groups(P<0.05).The postoperative pregnancy rate of the observation group was higher than that of the control group,and the difference was statistically significant between the two groups(χ^(2)=8.486,P=0.004).Conclusion The non-dilatation integrated hysteroscope system has high surgical safety in the treatment of moderate and severe intrauterine adhesions.Compared with the HEOS cold knife hysteroscopy system,the non-dilatation integrated hysteroscope system has advantages of short operation time,less intraoperative blood loss,no dilatation and higher postoperative pregnancy rate.