中外医学研究2024,Vol.22Issue(2) :32-37.DOI:10.14033/j.cnki.cfmr.2024.02.009

宫腔镜冷刀微剪分离术应用于重度IUA患者中的疗效及对其血清指标的影响

Effect of Hysteroscopic Cold-knife Micro-shear Separation in Patients with Severe IUA and Its Influence on Serum Indexes

潘静 李秀娟 陶朝慧
中外医学研究2024,Vol.22Issue(2) :32-37.DOI:10.14033/j.cnki.cfmr.2024.02.009

宫腔镜冷刀微剪分离术应用于重度IUA患者中的疗效及对其血清指标的影响

Effect of Hysteroscopic Cold-knife Micro-shear Separation in Patients with Severe IUA and Its Influence on Serum Indexes

潘静 1李秀娟 2陶朝慧1
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作者信息

  • 1. 黄冈市黄州区人民医院 湖北 黄冈 438000
  • 2. 武汉市蔡甸区人民医院
  • 折叠

摘要

目的:分析宫腔镜冷刀微剪分离术应用于重度宫腔粘连(IUA)患者中的疗效及对其血清指标的影响.方法:采取便利抽样的方法选取 2022 年 1 月—2023 年 1 月黄冈市黄州区人民医院妇产科收治的 80 例重度IUA患者作为研究对象,根据随机数表法将患者分为对照组与观察组,各 40 例.对照组予以宫腔镜电切手术,观察组予以宫腔镜冷刀微剪分离术,比较两组临床疗效、月经改善情况、子宫内膜动脉血流、子宫内膜厚度及血清指标.结果:观察组总有效率为 95.0%,高于对照组的 77.5%,差异有统计学意义(P<0.05);观察组月经恢复总有效率为 90.0%,高于对照组的 72.5%,差异有统计学意义(P<0.05);术后 30 d、90 d,两组子宫内膜动脉血流与子宫内膜厚度较术前显著改善,两组术后 90 d优于术后 30 d,且观察组阻力指数(RI)、搏动指数(PI)低于对照组,而子宫内膜厚度高于对照组,差异有统计学意义(P<0.05);术后30 d、90 d,两组血清指标较术前显著改善,两组术后 90 d优于术后 30 d,且观察组血清转化生长因子-β1(TGF-β1)、白细胞介素-6(IL-6)及纤溶酶原激活物抑制因子-1(PAI-1)水平均低于对照组,而基质金属蛋白酶-9(MMP-9)水平高于对照组,差异有统计学意义(P<0.05).结论:宫腔镜冷刀微剪分离术应用于重度IUA患者可取得显著效果,不仅能提升临床疗效及月经改善效果,还能促进子宫内膜动脉血流与子宫内膜厚度恢复,有效改善血清指标.

Abstract

Objective:To analyze the effect of effect of hysteroscopic cold-knife micro-shear separation in patients with severe intrauterine adhesions(IUA)and its influence on serum indexes.Method:Eighty patients with severe IUA who admitted to the Department of Obstetrics and Gynecology,Huangzhou District People's Hospital,Huanggang City from January 2022 to January 2023 were selected by convenient sampling,and they were the divided into the control group and the observation group according to the random number table method,with 40 cases in each group.The control group was given hysteroscopic electrotomy and the observation group was given hysteroscopic cold-knife micro-shear separation.The clinical efficacy,menstrual improvement,endometrial arterial blood flow,endometrial thickness and serum indexes of two groups were compared.Result:The total effective rate in the observation group was 95.0%,which was higher than 77.5%in the control group,and the difference was statistically significant(P<0.05);the total effective rate of menstrual recovery in the observation group was 90.0%,which was higher than 72.5%in the control group,and the difference was statistically significant(P<0.05).At 30 d and 90 d after surgery,the endometrial arterial blood flow and endometrial thickness in two groups were significantly improved than those before surgery,and those in two groups at 90 d after surgery were better than those at 30 d after surgery,the resistant index(RI)and pulsatility(PI)in the observation group were lower than those in the control group,while the endometrial thickness was higher than that in the control group,the differences were statistically significant(P<0.05);at 30 d and 90 d after surgery,the serum indexes in two groups were significantly improved compared with those before surgery,and the serum indexes of two groups at 90 d after surgery were better than those at 30 d after surgery,and the levels of serum transforming growth factor-β1(TGF-β1),interleukin-6(IL-6)and plasminogen activator inhibitor-1(PAI-1)in the observation group were lower than those in the control group,while the level of matrix metalloproteinase-9(MMP-9)were higher than those in the control group,the differences were statistically significant(P<0.05).Conclusion:Hysteroscopic cold-knife micro-shear separation can achieve significant results in patients with severe IUA,which can not only improve the clinical efficacy and menstrual improvement effect,but also promote the recovery of endometrial artery blood flow and endometrial thickness,as well as effectively improve serum indexes.

关键词

宫腔镜冷刀微剪分离术/重度宫腔粘连/子宫内膜动脉血流/子宫内膜厚度/血清指标

Key words

Hysteroscopic cold-knife micro-shear separation/Severe intrauterine adhesions/Endometrial arterial blood flow/Endometrial thickness/Serum index

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基金项目

湖北省卫生和计划生育委员会科研项目(WJ2017M244)

出版年

2024
中外医学研究
中国医院管理杂志社

中外医学研究

影响因子:1.149
ISSN:1674-6805
参考文献量20
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