宫腔镜冷刀微剪分离术后宫腔灌注粒细胞集落刺激因子对重度宫腔粘连患者的影响  

The effect of intrauterine infusion of granulocyte colony-stimulating factor on patients with severe intrauterine adhesions after hysteroscopic coldknife microsurgical separation

作　　者：张永会[1] 胡红娟[1] 钱艳平 Zhang Yonghui;Hu Hongjuan;Qian Yanping(Department of Gynecology,Yunnan Provincial Hospital of Traditional Chinese Medicine,Kunming Yunnan 650021,P.R.China)

机构地区：[1]云南省中医医院妇科,云南昆明650021

出　　处：《中国计划生育和妇产科》2024年第7期53-56,共4页Chinese Journal of Family Planning & Gynecotokology

摘　　要：目的分析宫腔镜冷刀微剪分离术后宫腔灌注粒细胞集落刺激因子(granulocyte colonystimulating factor,G-CSF)对重度宫腔粘连(intrauterine adhesions,IUA)患者的影响。方法回顾性选取2021年3月至2022年8月云南省中医医院重度IUA患者380例,所有患者均接受宫腔镜冷刀微剪分离术及雌孕激素序贯治疗,依照治疗方案分组,术后接受节育器干预为对照组(180例),术后接受节育器+宫腔灌注G-CSF干预为观察组(200例)。比较两组疗效、治疗前后宫腔镜下子宫内膜美国生育协会(AFS)评分、子宫内膜厚度、子宫动脉及内膜血流参数[子宫动脉搏动指数(PI)、阻力指数(RI)、子宫内膜血管化血流指数(VFI)、血管化指数(VI)],观察两组治疗后6个月的复发率和妊娠率。结果观察组术后3个月总有效率(96.50%)高于对照组(89.44%),差异有统计学意义(P<0.05)。治疗后,两组AFS评分均降低,且观察组低于对照组(P<0.05)。两组子宫内膜厚度均升高,且观察组高于对照组(P<0.05)。治疗后,两组PI、RI均较治疗前降低,观察组低于对照组,VFI、VI均较治疗前升高,且观察组高于对照组(P<0.05)。治疗后6个月,观察组复发率[34.72%(67/193)]低于对照组[55.90%(90/161)](P<0.05),组间妊娠率比较,差异无统计学意义(P>0.05)。结论宫腔镜冷刀微剪分离术后宫腔灌注G-CSF可有效改善重度IUA患者宫腔粘连情况、子宫内膜厚度、子宫动脉及内膜血流参数,降低复发风险。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 instillati

关 键 词：宫腔镜 微剪分离术 粒细胞集落刺激因子 重度宫腔粘连 血流参数 复发 

分 类 号：R711.74[医药卫生—妇产科学]