实用临床医药杂志2024，Vol.28Issue(20)：98-102,5.DOI:10.7619/jcmp.20242177
免扩宫宫腔镜技术与HEOS宫腔镜技术对宫腔粘连分离术的应用对比
Application of non-cervical dilation hysteroscopic technique versus HEOS hysteroscopic technique in intrauterine adhesion separation
摘要
Abstract
Objective To investigate the application value of different hysteroscopic techniques in the treatment of intrauterine adhesions(IUA)and their effects on vascularfunction indicators.Methods A total of 102 patients with IUA from June 2021 to December 2022 were selected as study subjects and divided into two groups based on the random number table method,with 51 patients in each group.Both groups underwent hysteroscopic cold knife adhesiolysis.The observation group a-dopted non-cervical dilation hysteroscopic technique,while the control group adopted HEOS hystero-scopic technique.Surgical-related indicators,surgical efficacy,menstrual improvement as well as stress response before and after surgery,vascular function-related factors,and endometrial blood flow were observed in both groups.Postoperative complications,recurrence,and clinical pregnancy within 1-year follow-up were also recorded.Results The operative time in the observation group was shor-ter,and the intraoperative blood loss was less than that in the control group(P＜0.05).There was no statistically significant difference in the total effective rate of surgical treatment between the obser-vation group and the control group(P＞0.05).The total improvement rate of menstruation in the ob-servation group was higher than that in the control group(P＜0.05).Levels of tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),and interleukin-6(IL-6)increased at 24 hours after surgery and decreased at 48 hours after surgery compared with levels at 24 hours after surgery in both groups.Additionally,the observation group had lower levels than the control group at 24 and 48 h after sur-gery(P＜0.05).At 1-and 3-month after surgery,serum hypoxia-inducible factor-1α(HIF-1α),vascular endothelial growth factor(VEGF),and tissue inhibitor of metalloproteinase-1(TIMP-1)levels decreased compared with pre-surgery levels in both groups,with the observation group show-ing lower levels than the control group(P＜0.05).At 1-and 3-month after surgery,vascularization index(VI),flow index(FI),and vascularization flow index(VFI)increased compared with pre-surgery levels in both groups,with the observation group showing higher levels than the control group(P＜0.05).The clinical pregnancy rate at 1-year follow-up in the observation group was higher than that in the control group(P＜0.05).Conclusion Both non-cervical dilation hysteroscopic technique and HEOS hysteroscopic technique have good clinical effects and safety in the treatment of moderate IUA,but the former can optimize the operation process,reduce perioperative stress re-sponse,and improve patients'hemodynamics and menstrual status.关键词
宫腔粘连/宫腔镜/冷刀分离术/免扩宫/应激反应/子宫内膜血流/复发/临床妊娠Key words
uterine adhesions/hysteroscopy/cold knife separation surgery/non-expansion of the uterus/stress response/endometrial blood flow/relapse/clinical pregnancy分类
医药卫生引用本文复制引用
王国莉,于雪梅,张瑛..免扩宫宫腔镜技术与HEOS宫腔镜技术对宫腔粘连分离术的应用对比[J].实用临床医药杂志,2024,28(20):98-102,5.基金项目
四川省绵阳市卫健委2022年科研课题鼓励项目(202264) （202264）
