宫腔镜冷刀微剪分离术对重度宫腔粘连患者手术相关指标及再粘连情况的影响

The effect of hysteroscopic cold knife micro-shear separation on surgical indexes and readhesion in patients with severe uterine adhesions

目的研究宫腔镜冷刀微剪分离术对重度宫腔粘连患者手术相关指标及再粘连情况的影响。方法选取50例重度宫腔粘连患者,按照投掷硬币法分为试验组与对照组,每组25例。对照组实施传统宫腔镜电切术治疗,试验组实施宫腔镜冷刀微剪分离术治疗。比较两组患者临床效果。结果试验组总有效率(96.00%)显著高于对照组(76.00%),差异有统计学意义(P<0.05)。试验组手术时间、住院时间均显著短于对照组,术中出血量、膨宫液吸收量显著少于对照组,差异有统计学意义(P<0.05)。试验组血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)及C-反应蛋白(CRP)水平均低于对照组,差异有统计学意义(P<0.05)。试验组术后妊娠率、月经恢复率显著高于对照组,宫腔再粘连率低于对照组,差异有统计学意义(P<0.05)。结论宫腔镜冷刀微剪分离术治疗重度宫腔粘连可明显提高临床效果,减轻炎性反应,降低再粘连发生,值得临床推广。

Objective To investigate the effects of hysteroscopic cold knife microshear separation on surgical indexes and readhesion in patients with severe intrauterine adhesions.Methods 50 severe intrauterine adhesions patients were selected and divided into experimental group and control group according to coin tossing method,with 25 cases in each group.The control group was treated with traditional hysteroscopic electrotomy,and the experimental group was treated with hysteroscopic cold knife micro-shear separation,The clinical effect of the two groups was compared.Results The total effective rate of experimental group(96.00%)was significantly higher than that of control group(76.00%),and the difference was statistically significant(P<0.05).The operative time and hospital stay of the experimental group were significantly shorter than those of the control group,and the intraoperative blood loss and dilatant fluid absorption were significantly less than those of the control group,with statistical significance(P<0.05).The serum levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and C-reactive protein(CRP)in experimental groups were lower than those in control group,and the differences were statistically significant(P<0.05).The pregnancy rate and menstrual recovery rate of experimental group were significantly higher than that of control group,and the uterine readhesion rate was lower than that of control group,with statistical significance(P<0.05).Conclusion Hysteroscopic cold knife micro-shear separation can significantly improve the clinical effect of severe intrauterine adhesions,reduce inflammatory response,reduce the occurrence of readhesion,worthy of clinical promotion.