仿生物电刺激联合激素促进稽留流产后内膜修复和预防宫腔粘连的效果分析

Analysis of the effect of imitation of bioelectricity stimulus combined with hormone in promoting endometrial repair and preventing intrauterine adhesion after missed abortion

目的探讨仿生物电刺激与雌孕激素联合促进稽留流产后子宫内膜修复和预防宫腔粘连的效果。方法选取2021年6月至2022年12月于深圳市南山区妇幼保健院治疗的稽留流产患者120例为研究对象,根据患者的入院顺序进行编号,按随机数字表法分为对照组(n=60)和联合组(n=60)。两组患者均在药物流产后行清宫术,对照组给予雌孕激素口服治疗,联合组在对照组的基础上联合仿生物电刺激治疗。比较两组患者术后腹痛持续时间、术后72h腹痛视觉模拟评分法(visual analogue scale,VAS)评分及术后当天、术后第15天、术后第1次月经来潮第15天的子宫内膜厚度、子宫螺旋动脉血流收缩末期峰值与舒张末期峰值的比值(end-systolic peak/end-diastolic peak,S/D)、搏动指数(pulsation index,PI)、阻力指数(resistance index,RI),并统计两组宫腔粘连的发生率。结果联合组患者术后腹痛持续时间和术后72h腹痛VAS评分均显著低于对照组(P<0.05)。联合组患者术后第15天、第1次月经来潮第15天的子宫内膜厚度均大于对照组,S/D、PI和RI均低于对照组(P<0.05)。治疗期间,联合组患者的宫腔粘连发生率为3.33%,对照组为13.33%,联合组显著低于对照组(P<0.05)。结论与单用雌孕激素治疗相比,仿生物电刺激联合雌孕激素修复稽留流产后患者的子宫内膜并预防宫腔粘连的效果更好,值得临床推广。

Objective To explore the effect of imitation of bioelectricity stimulus combined with estrogen and progesterone on promoting endometrial repair and preventing intrauterine adhesion after missed abortion.Methods A total of 120 patients with missed abortion treated in Shenzhen Nanshan Maternal and Child Health Care Hospital from June 2021 to December 2022 were selected as the research objects.The patients were numbered according to the order of admission,and they were divided into control group(n=60)and combined group(n=60)according to the random number table method.Both groups were treated with curettage after medical abortion.The control group was treated with estrogen and progesterone,and combined group was treated with imitation of bioelectricity stimulus on the basis of control group.The duration of postoperative abdominal pain,visual analogue scale(VAS)score of abdominal pain 72 hours after operation,endometrial thickness,the end-systolic peak/end-diastolic peak(S/D),pulsation index(PI)and resistance index(RI)on the day after operation,15 days after operation and 15 days after the first menstrual onset were compared between two groups.The incidence of intrauterine adhesions in two groups was counted.Results The duration of postoperative abdominal pain and VAS score of abdominal pain at 72 hours after operation in combined group were significantly lower than those in control group(P<0.05).The endometrial thickness of combined group was higher than that of control group 15 days after operation and 15 days after the first menstrual onset,and S/D,PI and RI were lower than those of control group(P<0.05).During the treatment,the incidence of intrauterine adhesion in combined group was 3.33%,which was significantly lower than 13.33%in control group(P<0.05).Conclusion Compared with the use of estrogen and progestins alone,imitation of bioelectricity stimulus combined with estrogen and progesterone can more effectively repair the endometrium and prevent the occurrence of intrauterine adhesion in patients with missed abortion,which is worthy of clinical promotion.