HEOS宫腔镜锐性分离对宫腔粘连患者手术相关指标子宫内膜厚度及复发情况的影响  

The influence of sharp separation of HEOS hysteroscopy on operation related indexes,endometrial thickness and recurrence of intrauterine adhesions

作　　者：姚燕婷[1] 赵霞[1] 宋勤[1] YAO Yan-Ting;ZHAO Xia;SONG Qin(Department of Obstetrics and Gynecology,Hangzhou Third People's Hospital,Hangzhou,Zhejiang310009,China)

机构地区：[1]杭州市第三人民医院妇产科,浙江杭州310009

出　　处：《中国妇幼保健》2022年第18期3476-3479,共4页Maternal and Child Health Care of China

基　　金：浙江省杭州市科技发展计划项目(20180533B62)。

摘　　要：目的探讨HEOS宫腔镜锐性分离对宫腔粘连患者手术相关指标、子宫内膜厚度及复发情况的影响。方法选取2018年5月—2019年12月杭州市第三人民医院收治的58例宫腔粘连患者,随机分为观察组30例和对照组28例,观察组患者采用HEOS宫腔镜锐性分离术,对照组患者采用宫腔镜剪刀分离法。比较两组术中相关指标(出血量、膨宫液吸收量及手术时间),术后月经、宫腔形态恢复情况;并观察术后两组宫腔粘连复发情况、两组术前及术后子宫内膜厚度的变化。结果观察组患者术中出血量(8.71±4.80)ml、术中膨宫液吸收量(121.47±45.28)ml及手术时间(16.94±2.63)min,对照组患者术中出血量(18.63±5.09)ml、术中膨宫液吸收量(360.82±122.35)ml及手术时间(24.78±3.16)min,两组相比,观察组明显少于对照组,差异均有统计学意义(均P<0.05)。观察组患者术后月经、宫腔形态恢复率分别为90.0%、93.3%与对照组患者的64.3%、67.9%相比明显增加,且观察组总有效率均较对照组明显增高,差异均有统计学意义(均P<0.05)。观察组患者术后2个月的宫腔粘连复发率为13.3%,与对照组患者的39.3%相比明显减少,差异有统计学意义(P<0.05)。观察组、对照组术前子宫内膜厚度分别为(4.71±1.12)mm、(4.65±1.39)mm,差异无统计学意义(P>0.05);术后3个月观察组、对照组子宫内膜厚度分别为(8.36±0.79)mm、(6.54±0.72)mm,两组患者子宫内膜厚度较术前均明显增加(均P<0.05),观察组子宫内膜厚度明显大于对照组(P<0.05)。结论HEOS宫腔镜锐性分离可增加宫腔粘连术后患者子宫内膜厚度,缩短手术时间、减少术中出血量及膨宫液吸收量,恢复患者正常月经、改善宫腔形态,还可防止宫腔粘连再次发生,值得临床推广应用。Objective To investigate the effect of sharp hysteroscopic separation of HEOS on operation related indexes,endometrial thickness and recurrence of intrauterine adhesions.Methods A total of 58 patients with intrauterine adhesions admitted to Hangzhou Third People's Hospital from May 2018 to December 2019 were randomly divided into the observation group 30 cases and the control group 28 cases.Patients in the observation group were treated with HEOS hysteroscopic sharp separation and patients in the control group were treated with hysteroscopic scissors separation.The intraoperative related indexes(bleeding volume,absorption of distended fluid and operation time),postoperative menstruation and recovery of uterine cavity morphology were compared between the two groups.The recurrence of intrauterine adhesions and the changes of endometrial thickness before and after operation were observed.Results The intraoperative bleeding volume(8.71±4.80)ml,the amount of intraoperative swelling fluid absorption(121.47±45.28)ml and the operation time(16.94±2.63)min in the observation group.The intraoperative bleeding volume(18.73±5.09)ml,the amount of intraoperative swelling fluid absorption(360.82±122.35)ml and the operation time(24.78±3.16)min in the control group.Compared between the two groups,the observation group was significantly less than the control group(P<0.05).The recovery rates of postoperative menstruation and uterine cavity morphology in the observation group were 90.0%and 93.3%respectively,which were significantly increased compared with 64.3%and 67.9%in the control group,the total effective rate in the observation group was significantly higher than that in the control group(P<0.05).The recurrence rate of intrauterine adhesions in the observation group was 13.3%two months after operation,which was significantly reduced compared with 39.3%in the control group(P<0.05).The endometrial thickness of the observation group and the control group were(4.71±1.12)mm and(4.65±1.39)mm respectively before operation,and t

关 键 词：宫腔粘连 HEOS宫腔镜锐性分离术 子宫内膜厚度 月经恢复 宫腔形态 

分 类 号：R713.4[医药卫生—妇产科学]