冷刀系统对中、重度宫腔粘连的诊治效果临床观察  

Clinical Observation of HEOS in the Treatment of Moderate and Severe Intrauterine Adhesions

作　　者：王超群[1] 孟丽燕[1] 高俊丽[1] 黄蓉霞[1] 牛洁[1] 陈建[1] WANG Chaoqun;MENG Liyan;GAO Junli;HUANG Rongxia;NIU Jie;CHEN Jian(Dept.of Gynecology,Kunming Maternal and Child Health Hospital,Kunming Yunnan 650032,China)

机构地区：[1]昆明市妇幼保健院妇科,云南昆明650032

出　　处：《昆明医科大学学报》2023年第3期125-130,共6页Journal of Kunming Medical University

基　　金：昆明市卫生科技“十百千工程培养”项目[2021-sw(后备)-60]。

摘　　要：目的 观察宫腔镜冷刀系统对拟行辅助生殖助孕的中、重度宫腔粘连患者的临床疗效及妊娠结局。方法 回顾性分析拟行辅助生殖的中、重度宫腔粘连的患者,按手术方式不同分为冷刀组及电能量组,收集所有患者的基本资料及手术资料,并随访患者的妊娠结局。结果 (1)共收集120例患者,其中冷刀组60例,电能量组60例。2组手术时间、术中出血量、术中并发症、术后妊娠率及活产率指标比较差异无统计学意义(P> 0.05)。其中冷刀组行2次手术后宫腔形态及内膜恢复达移植条件的占比:63.3%;电能量组占比:43.3%。术后妊娠时间冷刀组的中位妊娠月份为2.5月,要早于电能量组1月。(2)对于宫腔粘连的程度,冷刀组中、重度宫腔粘连患者的手术时间及术中出血量及术后妊娠率及活产率比较,差异无统计学意义(P> 0.05),电能量组重度宫腔粘连的患者手术时间及术中出血量均多于中度宫腔粘连,差异有统计学意义(P <0.05)。电能量组的重度粘连病例行2次手术达移植条件的患者为所有分组中最低,仅占7.7%。结论 对于需行胚胎移植的中、重度宫腔粘连的患者,运用宫腔镜冷刀系统手术安全、有效,且分解粘连达到满足行胚胎移植的内膜条件的手术次数相对电能量器械要更少。而对于移植后妊娠率来说,手术的方式及宫腔粘连的程度均不对妊娠率及活产率造成影响。Objective To observe the clinical efficacy and pregnancy outcome of hysteroscopic cold knife system in patients with moderate and severe intrauterine adhesions who planned to undergo assisted reproduction.Methods Patients with moderate and severe intrauterine adhesions who planned to undergo assisted reproduction were retrospectively analyzed and divided into cold knife group and electric energy group according to different surgical methods. The basic data and surgical data of all patients were collected,and the pregnancy outcomes of patients were followed up. Results (1) A total of 120 patients were collected in this experiment,including 60patients in cold knife group and 60 patients in electric energy group. There were no significant differences in operation time,intraoperative blood loss,intraoperative complications,postoperative pregnancy rate and live birth rate between the two groups(P > 0.05). In the cold knife group,the proportion of the uterine cavity shape and endometrium restored to the condition of transplantation after two operations was 63.3%;Electrical energy group accounted for 43.3%. The median gestational month of the cold knife group was 2.5 months,which was 1 month earlier than that of the electric energy group.(2) To the extent to which caused by intrauterine adhesions,cold knife group,patients with severe caused by intrauterine adhesions in operative time and intraoperative blood loss and postoperative pregnancy rate and live-birth rate no statistical difference(P > 0.05) electrical energy group of uterine cavity adhesion of surgery in patients with severe bleeding amount of time and have more moderate caused by intrauterine adhesions,and statistically significant(P < 0.005). In the electrical energy group,only 7.7% of the patients with severe adhesions who achieved transplantation conditions after two operations were the lowest among all groups. Conclusions For the patients with moderate and severe intrauterine adhesions who need embryo transfer,the hysteroscopic cold knife system is safe a

关 键 词：宫腔粘连 冷刀系统 诊治效果 

分 类 号：R713.4[医药卫生—妇产科学]