宫腔镜冷刀分离术后放置子宫球囊支架治疗宫腔粘连患者的临床疗效  

Alinical efficacy of uterine balloon stent placement after hysteroscopic cold knife separation in the treatment of patients with intrauterine adhesions

作　　者：何雅星 刘琴[1] 赵航[1] HE Yaxing;LU Qin;ZHAO Hang(Department of Gynecology,the 73rd Group Army Hospital of the People's Liberation Army of China,Xiamen 361000,Fujian,China)

机构地区：[1]中国人民解放军陆军七十三集团军医院妇科,福建厦门361000

出　　处：《中国性科学》2024年第7期48-52,共5页Chinese Journal of Human Sexuality

基　　金：2020年厦门市医疗卫生指导性项目(3502Z20209163)。

摘　　要：目的探究宫腔镜冷刀分离术后放置子宫球囊支架在宫腔粘连(IUA)患者中的临床应用效果,分析其对子宫动脉搏动指数(PI)、血流阻力指数(RI)、术后并发症、复发的影响。方法回顾性分析2022年7月至2023年7月中国人民解放军陆军七十三集团军医院收治的196例采用宫腔镜冷刀分离术治疗的IUA患者的临床资料。依据术后处理方式不同分为节育器组与支架组,每组98例。比较两组疗效、月经复潮时间,以及术前及术后子宫形态、子宫内膜血流指数和性激素水平,比较两组术后并发症发生率、术后6个月复发情况。结果支架组总有效率显著高于节育器组,差异具有统计学意义(P<0.05)。术后第3个月,两组子宫颈状态正常占比、子宫内膜厚度和宫腔容积显著高于术前,且支架组显著高于节育器组,差异具有统计学意义(P<0.05);支架组月经复潮时间显著短于节育器组,差异具有统计学意义(P<0.05)。术后第3个月,两组PI和RI均显著降低,血管-血流指数(VFI)显著升高,且支架组指标变化显著高于节育器组,差异具有统计学意义(P<0.05)。术后第3个月,两组卵泡刺激素(FSH)和黄体生成素(LH)水平均显著降低,雌二醇(E_(2))水平显著升高,且支架组指标变化显著高于节育器组,差异具有统计学意义(P<0.05)。两组术后并发症发生率比较,差异无统计学意义(P>0.05);支架组粘连复发率显著低于节育器组,差异具有统计学意义(P<0.05)。结论宫腔镜冷刀分离术后放置子宫球囊支架能有效促进IUA患者子宫形态与功能恢复,改善子宫内膜血流状况,减少粘连复发,安全性较高。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(E_(2

关 键 词：宫腔粘连 宫腔镜冷刀分离 子宫球囊支架 子宫内膜血流 并发症 

分 类 号：R711[医药卫生—妇产科学]