Clinical efficacy of uterine balloon stent placement after hysteroscopic cold knife separation in the treatment of patients with intrauterine adhesions
Objective To explore the clinical application effect of uterine balloon stent placement after hysteroscopic cold knife separation in patients with intrauterine adhesions(IUA),and to analyze its influence on uterine artery pulsatility index(PI),blood flow resistance index(RI),postoperative complications and recurrence.Methods The clinical data of IUA patients who underwent hysteroscopic cold knife separation treatment in the 73rd Group Army Hospital of the People's Liberation Army of China from July 2022 to July 2023 were retrospectively analyzed.According to different postoperative treatment methods,they were divided into intrauterine device(IUD)group and stent group,with 98 cases in each group.The efficacy,menstrual recovery time,preoperative and postoperative uterine morphology,endometrial blood flow indexes and sex hormones levels were compared,and the postoperative complications rate and the postoperative recurrence status within 6 months were compared.Results The total effective rate in stent group was significantly higher than IUD group,and the difference was statistically significant(P＜0.05).At 3 months after surgery,the proportion with normal cervical status,endometrial thickness and uterine cavity volume in the two groups were significantly higher than those before surgery,and the above indicators were significantly higher in stent group than those in IUD group,and the differences were statistically significant(P＜0.05).The menstrual recovery time was significantly shorter compared with that in IUD group,and the difference was statistically significant(P＜0.05).The PI and RI in both groups at 3 months after surgery were significantly decreased,the vascularization flow index(VFI)was significantly increased.The changes of the indicators in stent group were significantly higher,and the differences were statistically significant(P＜0.05).At 3 months after surgery,the levels of follicle-stimulating hormone(FSH)and luteinizing hormone(LH)in the two groups were decreased significantly,the level of estradiol(E2)was increased significantly,and the changes were significantly higher in stent group,and the differences were statistically significant(P＜0.05).There were no significant differences in the incidence rates of postoperative complications between the two groups(P＞0.05).The recurrence rate of adhesion was significantly lower than that in IUD group,and the difference was statistically significant(P＜0.05).Conclusions Uterine balloon stent placement after hysteroscopic cold knife separation can effectively promote the uterine morphology and function recovery,improve the endometrial blood flow status,and reduce the recurrence of adhesion in patients with IUA,with high safety.
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