宫腔镜和腹腔镜联合手术治疗宫腔粘连对患者月经改善及复发率的影响

Effect of combined hysteroscopic and laparoscopic surgery on improvement of menstruation and recurrence rate in patients with uterine adhesions

目的:探讨宫腔镜、腹腔镜联合手术治疗宫腔粘连对患者月经改善及复发率的影响。方法:选取我院2020年1月~2023年5月收治的76例宫腔粘连患者为研究对象。根据随机数字表法将76例患者均分为联合组(n=38)和宫腔镜组(n=38)。联合组实施宫腔镜、腹腔镜联合手术。宫腔镜组实施宫腔镜下宫腔粘连分离术。观察并比较两组患者治疗后的月经改善情况、粘连情况、复发率以及并发症发生率。结果:联合组显效例数和总有效率均高于宫腔镜组,而联合组无效例数则低于宫腔镜组(P<0.05)。两组患者美国生殖协会标准中粘连类型、粘连范围等维度评分均下降,且联合组低于宫腔镜组(P<0.05)。联合组总并发症发生率低于宫腔镜组(P<0.05)。术后3m,联合组复发率为5.26%,低于宫腔镜组的21.05%(P<0.05)。结论:宫腔镜和腹腔镜联合手术能够有效改善盆腔粘连患者的月经情况和宫腔粘连情况,降低患者再次发生宫腔粘连的可能性,提高安全性。

Objective:To investigate the effect of combined hysteroscopic and laparoscopic surgery on the improvement and recurrence of menstruation in patients with uterine adhesions.Methods:76 patients with intrauterine adhesions admitted to our hospital from January 2020 to May 2023 were selected as the study objects.The 76 patients were divided into the combined group(n=38)and the hysteroscopic group(n=38)according to random number table method.The combined group underwent hysteroscopic and laparoscopic surgery.Hysteroscopic adhesion separation was performed in the hysteroscopic group.The improvement of menstruation,adhesion,recurrence rate and complication rate were observed and compared between the two groups after treatment.Results:The number of effective cases and total effective rate in the combined group were higher than those in the hysteroscope group,while the number of ineffective cases in the combined group was lower than that in the hysteroscope group(P<0.05).The scores of adhesion type and adhesion range in the standards of American Reproductive Society in both groups were decreased,and the combined group was lower than the hysteroscopic group(P<0.05).The total complication rate of the combined group was lower than that of the hysteroscope group(P<0.05).Three months after surgery,the recurrence rate of the combined group was 5.26%,which was lower than 21.05%in the hysteroscopic group(P<0.05).Conclusion:Combined hysteroscopy and laparoscopy can effectively improve menstruation and intrauterine adhesions in patients with pelvic adhesions,reduce the possibility of recurrence of intrauterine adhesions,and improve safety.