宫腔镜下冷刀技术治疗宫腔粘连患者子宫内膜厚度及效果的分析

Analysis of Endometrial Thickness and Effect of Hysteroscopic Cold Knife Technique in Treatment of Uterine Adhesions

目的分析宫腔镜下冷刀技术对宫腔粘连的治疗效果及对子宫内膜厚度的影响。方法选择2022年5月—2023年5月福建医科大学附属福州市第一医院妇科治疗宫腔粘连的100例患者作为研究对象,以电脑软件随机抽取其中50例作为对照组,另外50例作为研究组。对照组采取宫腔镜下等离子电切手术,研究组采取宫腔镜下冷刀微剪手术。对比2组的临床疗效、手术用时、住院天数、膨宫液使用剂量、术中失血量、术后3个月复发率以及治疗前后的宫腔容积和子宫内膜厚度、并发症。结果研究组总有效率为98.00%,高于对照组的82.00%,差异有统计学意义(P<0.05);术后3个月研究组复发率为4.00%,对照组为24.00%,组间对比,差异有统计学意义(P<0.05)。与对照组比较,研究组的住院天数和手术用时相对更短,膨宫液使用量和术中失血量相对更少,差异有统计学意义(P<0.05)。采用一般线性模型对治疗前后不同组别的患者宫腔容积和子宫内膜厚度的对比分析,治疗前,2组宫腔容积、子宫内膜厚度比较,差异无统计学意义(P>0.05),治疗后,研究组具有比对照组更大的宫腔容积和更理想的子宫内膜厚度,差异均有统计学意义(P<0.05)。研究组无并发症发生,对照组虽有2例但与研究组相比,差异无统计学意义(P>0.05)。结论相较于宫腔镜下等离子电切手术,宫腔镜下冷刀技术对宫腔粘连的治疗效果更加显著,带来的创伤更小,安全性更高,患者术后恢复快,复发率低,且宫腔容积和子宫内膜厚度也可以得到更加显著地改善。

Objective To observe the effect of hysteroscopic cold knife treatment on patients with intrauterine adhesions and the changes of endometrial thickness and other indicators.Methods From May 2022 to May 2023,a total of 100 patients with intrauterine adhesions treated in the department of gynecology,Fuzhou First Hospital Affiliated to Fujian Medical University were selected as the study objects.50 patients were randomly selected by computer software as the control group,and the other 50 patients were selected as the study group.The control group was treated with hysteroscopic plasma resection,and the study group was treated with hysteroscopic cold knife micro-scissors.The clinical efficacy,operation time,hospital stay,dosage of uterine distension solution,intraoperative blood loss,recurrence rate 3 months after operation,uterine cavity volume,endometrial thickness and complications before and after treatment were compared between the two groups.Results The total effective rate of the study group was 98.00%,which was higher than that of the control group(82.00%),and the difference was statistically significant(P<0.05).The recurrence rate of the study group was 4.00% and that of the control group was 24.00% at 3 months after operation,and the difference was statistically significant(P<0.05).Compared with the control group,the length of hospital stay,operation time in the study group were relatively shorter,and the amount of uterine distension fluid used and intraoperative blood loss were relatively less,with statistical significance(P<0.05).General linear model was used to compare and analyze the uterine cavity volume and endometrial thickness of different groups of patients before and after treatment.Before treatment,there was no significant difference in uterine cavity volume and endometrial thickness between the two groups(P>0.05).After treatment,the study group had larger uterine cavity volume and better endometrial thickness than the control group,and the differences were statistically significant(P<0.05).No complications occurred in the study group,although there were 2 cases in the control group,there was no significant difference compared with the study group,and the difference was not statistically significant(P>0.05).Conclusion The treatment effect of hysteroscopic cold knife technique on intrauterine adhesions is more significant than that of hysteroscopic plasma resection,with less trauma,higher safety,faster postoperative recovery,lower recurrence rate,and more significant improvement of uterine cavity volume and endometrial thickness.