重组牛碱性成纤维细胞生长因子凝胶对宫腔镜下宫腔粘连切除术患者的效果研究

Effects of recombinant bovine basic fibroblast growth factor gel therapy on microvessel density and vascular endothelial growth factor after hysteroscopic resection of intrauterine adhesions

目的研究宫腔镜下宫腔粘连切除术后应用重组牛碱性成纤维细胞生长因子凝胶治疗对微血管密度(MVD)和血管内皮生长因子(VEGF)的影响。方法将2016年1月至2019年1月时期收治120例择期行超声监测下行宫腔镜下宫腔粘连切除术患者以随机数字表法分成对照组与试验组,每组60例。试验组患者术后以重组牛碱性成纤维细胞生长因子凝胶治疗,对照组患者则以透明质酸钠治疗,并对2组患者进行12个月的有效随访。比较2组患者术后情况(术后不同时间内出血量、出血停止时间、腹痛消失时间),月经复潮情况(复潮时间、复潮月经量、腹痛率),术前、术后7 d MVD水平和VEGF表达,随访期间再次粘连的发生率。结果试验组患者术后不同时间内出血量明显少于对照组,而试验组患者出血停止时间、腹痛消失时间均短于对照组,差异均有统计学意义(P<0.01)。试验组患者月经复潮时间明显短于对照组,复潮月经量多于对照组,而月经复潮腹痛率低于对照组,差异均有统计学意义(P<0.05)。2组患者术前、术后7 d MVD水平和VEGF表达差异无统计学意义(P>0.05)。术后MVD水平和VEGF表达较术前明显下降,其中试验组均低于对照组,差异有统计学意义(P<0.05)。结论在超声监测下行宫腔镜下实施的宫腔粘连切除术后,应用重组牛碱性成纤维细胞生长因子凝胶治疗,可明显减少患者术后不同时间段内的出血量,缩短患者出血停止时间与腹痛症状消失时间,缩短月经复潮时间降低VEGF表达率与MVD水平,减少随访期间的宫腔再次粘连的发生率,效果理想。

Objective To investigate the effects of recombinant bovine basic fibroblast growth factor(Beifuxin)on microvessel density(MVD)and vascular endothelial growth factor(VEGF)after hysteroscopic resection of intrauterine adhesions.Methods A total 120 patients who underwent hysteroscopic resection of adhesions in our hospital from January 2016 to January 2019 were enrolled in the study,who were were randomly divided into control group(n=60)and experimental group(n=60).The patients in control group were treated by Beifuxin after operation,however the patients in experimental group were treated by sodium hyaluronate.The 12-month followed-up were performed for both groups.The postoperation situations including bleeding volume,the bleeding offtime,the abdominal pain disappearing time,the menstruation resume time(the time of resuming menstruation,the amount of resuming menstruation,the rate of abdominal pain),and the levels of MVD and VEGF as well as the incidence of readhesion were observed and compared between the two groups.Results The amount of bleeding in experimental group at different time points was significantly less than that in control group,while the bleeding stopping time and the disappearance time of abdominal pain in experimental group were significantly shorter than those in control group(P<0.01).The menstruation resume time in experimental group was signifiantly shorter than that in control group,the amount of menstruation was significantly more than that in control group,however the incidence of abdominal pain was significantly lower than that in control group(P<0.05).There were no significant differences in the levels of MVD and VEGF between the two groups(P>0.05).After operation the levels of MVD and VEGF in experimental group were significantly lower than those before operation,moreover,which in experimental group were significantly lower than those in control group(P<0.05).Conclusion The application of Beifuxin after hysteroscopic resection of intrauterine adhesions can obviously reduce the amount of bleeding in different time points,shorten bleeding stopping tiem and the disappearance time of abdominal pain symptoms,shorten the recovery time of menstruation,decrease the expression levels of VEGF and MVD,and decrease the incidence of intrauterine adhesions,and its effects are satisfactory.