富血小板血浆对宫腔粘连分离术后内膜修复和子宫内膜容受性及妊娠结局的影响研究

Effect of Platelet-rich Plasma on Endometrial Repair and Endometrial Tolerance and Pregnancy Outcome after Separation of Uterine Adhesions

目的:分析富血小板血浆(platelet-rich plasma,PRP)对宫腔粘连分离术(transcervical resection of adhesion,TCRA)后修复内膜改善子宫内膜容受性及妊娠结局的影响。方法:选取2018年9月—2020年9月濮阳市妇幼保健院接受TCRA治疗第一周期后常规治疗无效的50例患者作为研究对象,进行自身对照。第二周期时给予患者PRP宫腔灌注。对比TCRA术前、第一周期后及PRP灌注治疗后子宫内膜厚度及内膜容积(Vascularization index,VI)、血流指数(Blood flow index,FI)、血管化血流指数(Vascularized blood flow index,VFI)、子宫内膜下血流分型及妊娠情况进行对比。结果:与术前比较,所有患者第一周期及PRP灌注治疗后内膜厚度、内膜容积、VI、FI、VFI均有所升高,且PRP灌注治疗后变化均高于第一周期后,差异有统计学意义(F=50.40、316.31、45.51、65.91、208.56、172.76、114.05、206.92、P<0.05)。PRP灌注治疗后妊娠率高于TCRA术后第一周期。结论:TCRA术后给予PRP宫腔灌注治疗可促进内膜生长,改善子宫内膜容受性,提高妊娠率。

Objective:To analyze the effect of platelet-rich plasma(PRP)on endometrial repair after transcervical resection of adhesion(TCRA)to improve endometrial tolerance and pregnancy outcome.Methods:50 patients who were ineffective in conventional treatment after the first cycle of TCRA treatment in the hospital from September 2018 to September 2020 were selected as study subjects for their own control.PRP uterine perfusion was given during the second cycle.Endometrial thickness and endometrial volume,vascularization index(VI),blood flow index(FI),vascularized blood flow index(VFI),subendometrial blood flow typing and pregnancy were compared before TCRA,after the first cycle and after PRP perfusion therapy.Results:Endothelial thickness,endothelial volume,VI,FI,and VFI were elevated in all study subjects after the first cycle and PRP perfusion treatment compared to preoperatively,and the changes were higher after PRP perfusion treatment than after the first cycle,with statistically significant differences(F=50.40,316.31,45.51,65.91,208.56,172.76,114.05,206.92,P<0.05).Pregnancy rates were higher after PRP infusion therapy than after the first cycle of TCRA.Conclusion:The administration of PRP intrauterine perfusion therapy after TCRA promotes endometrial growth,improves endometrial tolerance,and increases pregnancy rates.