The effect of intrauterine infusion of granulocyte colony-stimulating factor on patients with severe intrauterine adhesions after hysteroscopic cold-knife microsurgical separation
Objective To analyze the effect of intrauterine instillation of granulocyte colony-stimulating factor(G-CSF)after hysteroscopic cold-knife microshear detachment in patients with severe intrauterine adhesions(IUA).Methods A total of 380 patients with severe IUA in Yunnan Provincial Hospital of Traditional Chinese Medicine were retrospectively selected from March 2021 to August 2022.All patients were treated with hysteroscopic cold-knife microsurgery and estrogen-progestogen sequential therapy,According to the treatment plan,the control group(180 cases)received IUD intervention after surgery,and the observation group(200 cases)received IUD+G-CSF intervention after surgery.Compared the efficacy,hysteroscopic endometrial American Fertility Society(AFS)score,endometrial thickness,uterine arterial and endometrial blood flow parameters[uterine arterial pulsatility index(PI),resistance index(RI),endometrial vascularized flow index(VFI),vascularization index(VI)]before and after the treatment,and observed the the recurrence rates and pregnancy rates at 6 months after treatment between the two groups.Results The total effective rate of the observation group(96.50％)was higher than that of the control group(89.44％),and the difference was statistically significant(P＜0.05).After treatment,AFS scores were reduced in both groups,and the observation group was lower than the control group(P＜0.05),endometrial thickness was elevated in both groups,and endometrial thickness was higher in the observation group than in the control group(P＜0.05).After treatment,PI and RI in both groups were lower than before treatment,and the observation group was lower than the control group,VFI and VI were higher than before treatment,and the observation group was higher than the control group(P＜0.05).Six months after treatment,the recurrence rate of observation group[34.72％(67/193)]was lower than that of control group[55.90％(90/161)](P＜0.05),and there was no significant difference in pregnancy rate between groups(P＞0.05).Conclusion Uterine instillation of G-CSF after hysteroscopic cold-knife microshear separation can effectively improve the uterine adhesion status,endometrial thickness,uterine arterial and endometrial blood flow parameters,and reduce the risk of recurrence in patients with severe IUA.
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