宫腔镜下冷刀微剪分离术治疗对宫腔粘连患者月经及宫腔形态恢复的影响

Effect of Hysteroscopic Cold Knife Microshear Separation on Menses and Uterine Shape Recovery in Patients with Uterine Adhesions

目的研讨宫腔镜下冷刀微剪分离术治疗对宫腔粘连患者月经及宫腔形态恢复的影响。方法方便选取2021年3月—2023年6月大田县总医院收治的64例宫腔粘连患者为研究对象,依据治疗术式分为对照组和观察组,每组32例。对照组接受传统宫腔镜下电切术处理,观察组接受宫腔镜下冷刀微剪分离术处理,对比两组的手术效果、手术基础指标、月经改善状况、宫腔形态恢复状况以及术后并发症。结果观察组手术总有效率(96.88%)高于对照组的(75.00%),差异有统计学意义(χ^(2)=4.654,P=0.030)。观察组各项手术基础指标(术中出血量、膨宫液吸收量、手术及住院时间)均优于对照组,差异有统计学意义(P均<0.05)。观察组月经改善、宫腔形态恢复患者的占比均高于对照组,差异有统计学意义(P均<0.05)。观察组术后出现并发症的患者总占比少于对照组,差异有统计学意义(P<0.05)。结论宫腔镜下冷刀微剪分离术用于宫腔粘连患者的处理效果确切,对患者月经改善及宫腔形态恢复有明显助益,且术后并发症发生率低,手术安全性较高。

Objective To study the effect of hysteroscopic cold knife microshear separation on menses and uterine shape recovery in patients with uterine adhesions.Methods A total of 64 patients with intrauterine adhesions in Datian County General Hospital from March 2021 to June 2023 were conveniently selected as study objects,and they were divided into the control group and the observation group by treatment methods,with 32 cases in each group.The control group underwent traditional hysteroscopic electrotomy,and the observation group underwent hysteroscopic cold knife microshear separation.The surgical effect,basic indexes,menses improvement,uterine shape recovery and postoperative complications were compared between the two groups.Results The total effective rate of the observation group(96.88%)was higher than that of the control group(75.00%),the difference was statistically significant(χ^(2)=4.654,P=0.030).The basic surgical indexes(intraoperative blood loss,dilatatory fluid absorption,operation and hospital stay)in the observation group were better than those in the control group,the differences were statistically significant(all P<0.05).The proportion of patients with menses improvement and uterine shape recovery in observation group were higher than that in control group,the differences were statistically significant(both P<0.05).The total proportion of postoperative complications in observation group was less than that in control group,the difference was statistically significant(P<0.05).Conclusion Hysteroscopic cold knife microshear separation is effective in the treatment of patients with intrauterine adhesions,and has obvious benefits for the improvement of menstruation and the recovery of uterine shape,and the incidence rate of postoperative complications is low,and the surgical safety is more guaranteed.