宫腔镜下冷刀切除术与双极电切术治疗宫腔粘连的临床效果对比OA
Comparison of Clinical Effects between Hysteroscopic Cold Knife Resection and Bipolar Electrosurgery in the Treatment of Intrauterine Adhesions
目的:探讨宫腔镜下冷刀切除术与双极电切术治疗宫腔粘连的临床效果.方法:选择2021年1月—2024年7月宜昌市中心人民医院收治的288例宫腔粘连患者,采用随机数字表法分为对照组(n=144)和观察组(n=144),分别行宫腔镜双极电切术和宫腔镜冷刀切除术.比较两组患者手术相关指标、子宫内膜厚度、粘连复发情况、妊娠情况及并发症发生情况.结果:观察组手术时间、术中出血量、膨宫液使用量、住院时间均少于对照组(均P＜0.05).术后2个月,观察组患者子宫内膜厚度[(9.52±1.52)mm vs(8.69±1.27)mm]显著高于对照组(P＜0.05).观察组患者总妊娠率(90.28％vs 79.17％)高于对照组,粘连复发率(6.94％vs 20.83％)低于对照组(均P＜0.05).观察组和对照组患者并发症总发生率(3.47％vs 4.17％)差异无统计学意义(P＞0.05).结论:宫腔镜下冷刀切除术治疗宫腔粘连的效果确切,可有效减少手术时间、术中出血及住院时间,改善子宫内膜厚度,明显降低宫腔粘连复发率,且安全性良好.
Objective:To assess the clinical effectiveness of hysteroscopic cold knife resection and bipolar electrocautery techniques for managing intrauterine adhesions.Methods:A total of 288 patients with intrauterine adhesions treated in Yichang Central People's Hospital from January 2021 to July 2024 were randomly divided into a control group(n=144)and an observation group(n=144)using a random number table method.They underwent hysteroscopic bipolar resection and hysteroscopic cold knife resection,respectively.The surgical related indicators,endometrial thickness,adhesion recurrence,pregnancy outcomes,and incidence of complications were compared between the two groups.Results:The observation group had less surgical time,intraoperative bleeding,use of uterine distension fluid,and hospital stay than those of control group(all P＜0.05).Two months after the operation,the endometrial thickness of patients in the observation group[(9.52±1.52)mm vs(8.69±1.27)mm]was significantly higher than that of the control group(P＜0.05).The total pregnancy rate of the observation group(90.28％vs 79.17％)was higher than that of the control group,and the recurrence rate of adhesions(6.94％vs 20.83％)was significantly lower than that of the control group(both P＜0.05).There was no statistically significant difference in the total incidence of complications between the observation group and the control group(3.47％vs 4.17％)(P＞0.05).Conclusion:The cold knife resection under hysteroscopy has a definite effect on the treatment of intrauterine adhesions,which can effectively reduce surgical time,intraoperative bleeding,and hospitalization time,improve endometrial thickness,significantly reduce the recurrence rate of intrauterine adhesions,and has good safety.
陈力;叶红;韩庆;曾淑华
三峡大学第一临床医学院[宜昌市中心人民医院]妇科,湖北宜昌 443003三峡大学第一临床医学院[宜昌市中心人民医院]妇科,湖北宜昌 443003三峡大学第一临床医学院[宜昌市中心人民医院]妇科,湖北宜昌 443003三峡大学第一临床医学院[宜昌市中心人民医院]妇科,湖北宜昌 443003
医药卫生
宫腔镜下冷刀切除术宫腔镜双极电切术宫腔粘连
hysteroscopic cold knife resectionhysteroscopic bipolar electrosurgeryintrauterine adhesions
《巴楚医学》 2026 (1)
45-50,6
湖北省自然科学基金项目(2024AFD189)
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