Comparison of effects of hysteroscopic cold knife separation and electrocision in treatment of patients with moderate to severe intrauterine adhesions
Objective:To compare effects of hysteroscopic cold knife separation and electrocision in treatment of patients with moderate to severe intrauterine adhesions.Methods:The clinical data of 84 patients with moderate to severe intrauterine adhesions admitted to this hospital from October 2021 to June 2023 were retrospectively analyzed.According to different treatment options,they were divided into study group and control group,42 cases in each group.The control group underwent hysteroscopic electrocision,while the study group underwent hysteroscopic cold knife separation.The perioperative index levels,the clinical efficacy,the endometrial thickness,the uterine cavity volume,the menstrual volume,the sex hormones[serum luteinizing hormone(LH),estradiol(E2),follicle stimulating hormone(FSH)]levels,the inflammatory indicators[interleukin-8(IL-8),C-reactive protein(CRP),matrix metalloproteinase-9(MMP-9),transforming growth factor-β1(TGF-β1)]levels before and after the surgery,and the incidence of complications were compared between the two groups.Results:The intraoperative blood loss in the study group was less than that in the control group,the operation time and the hospitalization time were shorter than those in the control group,and the differences were statistically significant(P＜0.05).The total effective rate of treatment in the study group was 97.62%(41/42),which was higher than 78.57%(33/42)in the control group,and the difference was statistically significant(P＜0.05).Three months after the surgery,the endometrial thickness and the uterine cavity volume of the two groups were greater than those before the surgery,and those in the study group were greater than those in the control group;the menstrual volume of the two groups were more than those before the surgery,and that in the study group was more than that in the control group;and the differences were statistically significant(P＜0.05).Three months after the surgery,the levels of serum FSH and LH in the two groups were lower than those before the surgery,and those in the study group were lower than those in the control group;the level of E2 in both groups were higher than those before the surgery,and that in the study group was higher than that in the control group;and the differences were statistically significant(P＜0.05).Three days after the surgery,the levels of serum CRP and IL-8 in the two groups were higher than those before the surgery,but those in the study group were lower than those in the control group;the serum MMP-9 levels of the two groups were higher than those before the surgery,and that in the study group was higher than that in the control group;the levels of TGF-β1 in the two groups were lower than those before the surgery,and that in the study group was lower than that in the control group;and the differences were statistically significant(P＜0.05).Further,the incidence of complications in the study group was lower than that in the control group,and the difference was statistically significant(P＜0.05).Conclusions:Hysteroscopic cold knife separation in the treatment of the patients with moderate to severe intrauterine adhesions can promote the recovery of uterine cavity morphology,regulate the levels of serum sex hormones and the inflammatory indicators,and reduce the incidence of complications.Moreover,it is superior to hysteroscopic electrocision.
万方数据
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