宫腔镜下冷刀分离术联合雌激素辅助ERAS对宫腔粘连患者炎性因子的影响
Effect of hysteroscopic cold knife separation combined with estrogen-assisted enhanced recovery after surgery on inflammatory factors of patients with intrauterine adhesions
李海燕 1王晓静 1史丽娟 1梁汉波 1张娜娜1
作者信息
- 1. 050011 河北省石家庄市人民医院妇科
- 折叠
摘要
目的 探讨宫腔镜下冷刀分离术联合雌激素辅助快速康复外科(ERAS)对宫腔粘连患者炎性因子的影响.方法 选择2019年10月至2022年10月收治的宫腔粘连患者100例,随机分为2组,每组50例.对照组采用宫腔镜下冷刀分离术联合雌激素治疗,观察组在对照组基础上辅助ERAS,比较2组术后1、3个月的临床疗效.分别在术前、术后3 d抽取2组患者空腹静脉血5 mL,采用酶联免疫吸附法(ELISA),试剂盒测定C-反应蛋白(CRP)水平、白介素-6(IL-6)水平、白介素-8(IL-8)水平、肿瘤坏死因子-α(TNF-α)水平.统计术后并发症发生率,包括腹痛、出血、再粘连.结果 术后1个月及术后3个月,观察组临床疗效均高于对照组(P＜0.05).术后3 d,2组患者CRP水平、TNF-α水平均低于术前,IL-6水平、IL-8水平均高于术前(P＜0.05).而观察组CRP水平、TNF-α水平均低于对照组,IL-6水平、IL-8水平均高于对照组(P＜0.05).2组术后并发症发生率比较,观察组低于对照组(P＜0.05).结论 宫腔镜下冷刀分离术联合雌激素辅助ERAS较宫腔镜下冷刀分离术联合雌激素比较,可提高临床疗效,改善患者炎性因子水平,降低术后并发症发生率.
Abstract
Objective To investigate the effect of hysteroscopic cold knife separation combined with estrogen-assisted enhanced recovery after surgery(ERAS)on inflammatory factors of patients with intrauterine adhesions.Methods A total of 100 patients with intrauterine adhesions admitted from October 2019 to October 2022 were selected as the study subjects.They were randomly divided into the control group(n=50)and the observation group(n=50).Patients in both groups were treated with hysteroscopic cold knife separation combined with estrogen therapy,and those in the observation group were additionally given ERAS-based clinical management.The clinical efficacy at 1 month and 3 months postoperatively was compared.5 mL of fasting venous blood was drawn before and 3 days after operation,and serum samples were obtained by centrifugation.The levels of C-reactive protein(CRP),interleukin-6(IL-6),interleukin-8(IL-8)and tumor necrosis factor-α(TNF-a)were recorded.The incidence of postoperative complications,including abdominal pain,bleeding and re-adhesion,was calculated.Results The clinical efficacy at 1 month and 3 months postoperatively in the observation group was significantly higher than that of the control group(P＜0.05).CRP and TNF-α levels on 3 days postoperatively in both groups were significantly lower than those before surgery(P＜0.05),while IL-6 and IL-8 levels were significantly higher(P＜0.05).Patients in the observation group had significantly lower CRP and TNF-α levels on 3 days postoperatively,and higher IL-6 and IL-8 levels than those of control group(P＜0.05).The incidence of postoperative complications in the observation group was significantly lower than that of the control group(P＜0.05).Conclusion Hysteroscopic cold knife separation combined with estrogen-assisted ERAS can improve the clinical efficacy,alleviate inflammatory factors and reduce the incidence of postoperative complications compared with hysteroscopic cold knife separation combined with estrogen therapy.
关键词
宫腔镜/冷刀分离术/雌激素/快速康复外科/宫腔粘连/炎症因子Key words
hysteroscopy/cold knife separation/estrogen/enhanced recovery after surgery/intrauterine adhesions/inflammatory factor引用本文复制引用
出版年
2024
NETL
NSTL
维普
万方数据