深部热疗联合小剂量阿司匹林对薄型子宫内膜患者宫腔镜术后粘连预防效果分析

Analysis of the preventive effect of deep hyperthermia combined with lowdose aspirin on adhesion after hysteroscopic surgery in patients with thin endometrium

目的分析深部热疗联合小剂量阿司匹林对薄型子宫内膜患者宫腔镜术后宫腔粘连(IUA)预防效果及对子宫内膜血流、组织微血管密度(MVD)及血管内皮生长因子(VEGF)水平的影响。方法选择2019年1月至2021年12月在青海省第五人民医院接受宫腔镜手术治疗的86例薄型子宫内膜患者,按随机对照原则分组,对照组(43例)口服小剂量阿司匹林治疗,研究组(43例)在上述基础上联合深部热疗,均于术后次日开展治疗,持续治疗4周。对比两组临床疗效、IUA分级、子宫内膜厚度及血流参数、MVD、VEGF。结果研究组治疗总有效率高于对照组(P<0.05);治疗后,研究组轻度、中度、重度IUA分级均低于对照组(P<0.05);治疗后,研究组子宫内膜厚度高于对照组,PI、RI低于对照组,内膜血管支数多于对照组,MVD、VEGF均高于对照组,差异均有统计学意义(P<0.05)。结论深部热疗联合小剂量阿司匹林可促进薄型子宫内膜患者内膜生长,提高其子宫内膜活性,具有显著疗效,且该治疗方案可提高患者宫腔镜术后粘连预防效果,改善内膜血流情况,调节MVD、VEGF水平。

Objective To analyze the effect of deep hyperthermia combined with low-dose aspirin on the prevention of intra uterine adhesion(IUA)in patients with thin endometrium after hysteroscopic surgery,and the effects on endometrial blood flow,tissue microvascular density(MVD)and vascular endothelial growth factor(VEGF)levels.Methods A total of 86 patients with thin endometrium who received hysteroscopic surgery in the Fifth People's Hospital of Qinghai Province from January 2019 to December 2021 were selected and divided into two groups according to the randomized control principle.The control group(43 cases)received oral low-dose aspirin therapy,and the study group(43 cases)received combined deep hyperthermia on the basis of the above,all of which were treated the next day after surgery and continued for 4 weeks.The clinical efficacy,IUA grade,endometrial thickness and blood flow parameters,MVD and VEGF were compared between the two groups.Results The total effective rate of the study group was higher than that of the control group(P<0.05).After treatment,mild,moderate and severe IUA grades in the study group were lower than those in the control group(P<0.05).After treatment,the endometrial thickness of the study group was higher than that of the control group,the PI and RI were lower than that of the control group,and the number of endometrial vessels was higher than that of the control group and MVD and VEGF were higher than that of the control group,with statistical significance(P<0.05).Conclusion Deep hyperthermia combined with low-dose aspirin can promote endometrial growth and enhance endometrial activity in patients with thin endometrium,which has significant curative effect.Moreover,this treatment regimen can improve the adhesion prevention effect of patients with hysteroscopic surgery,improve endometrial blood flow,and regulate the levels of MVD and VEGF.