【摘要】 目的 观察宫腔镜下冷刀技术治疗宫腔粘连的效果以及对患者子宫内膜的保护作用。方法 选择于医院治疗的110例宫腔粘连患者为研究对象，以随机数字表法对患者分组，55例患者为观察组，55例患者为对照组。对照组给予患者宫腔镜下电切手术治疗，观察组给予宫腔镜下冷刀手术治疗。治疗前、后检测两组患者白细胞介素-10（IL-10）、白细胞介素-6（IL-6）、白细胞介素-4（IL-4）、基质金属蛋白酶-9（MMP-9）、纤溶酶原激活物抑制因子-1（PAI-1）、转化生长因子-β1（TGF-β1）、雌二醇（E₂）、促卵泡刺激素（FSH）、促黄体生成素（LH）、卵泡刺激素（T）、宫动脉指数（PI）、子宫动脉阻力指数（RI）水平，测量两组患者子宫内膜厚度，记录两组患者手术时间、术中出血量、术后住院时间、月经改善率，比较两组患者临床疗效及宫腔再粘连发生率。结果 观察组IL-4、IL-10水平高于对照组（P<0.05）,观察组IL-6水平低于对照组（P<0.05）。观察组PAI-1、TGF-β1水平低于对照组（P<0.05）,观察组MMP-9水平高于对照组（P<0.05）。观察组LH、FSH、T水平低于对照组（P<0.05）,观察组E₂水平高于对照组（P<0.05）。观察组患者PI、RI水平低于对照组（P<0.05）。观察组子宫内膜厚度高于对照组（P<0.05）。观察组患者手术时间、术中出血量、术后住院时间低于对照组（P<0.05）。观察组月经改善率（96.36%）高于对照组（81.81%）（P<0.05）,观察组患者总有效率（98.18%）高于对照组（83.64%）（P<0.05）,观察组患者宫腔再粘连发生率（5.46%）低于对照组（27.27%）。结论 宫腔镜下冷刀技术治疗宫腔粘连患者，可抑制患者炎症，调节患者TGF-β1、PAI-1、MMP-9水平及激素水平，调节卵巢供血功能，保护患者子宫内膜，提升患者临床疗效，降低宫腔再粘连发生率。更多还原

【Abstract】 Objective To observe the effect of hysteroscopic cold knife technique on the treatment of intrauterine adhesions and the protection of endometrium. Methods 110 cases of patients with intrauterine adhesions were selected as the research objects and randomly divided into research group(n=55) and control group(n=55). The control group was treated with hysteroscopic electrosurgical operation, while the research group was treated with hysteroscopic cold knife operation. Interleukin-6(IL-6), interleukin-4(IL-4), matrix metalloproteinase-9(MMP-9), plasminogen activator inhibitor-1(PAI-1), transforming growth factor-β1(TGF-β1) estradiol(E2), follicle stimulating hormone(FSH), luteinizing hormone(LH), follicle stimulating hormone(T), uterine artery index(PI) and uterine artery resistance index(RI) were measured. The endometrial thickness, operation time, intraoperative blood loss, postoperative hospital stay and menstrual improvement rate were recorded. The clinical efficacy and the incidence of intrauterine adhesions were compared between the two groups. Results The levels of IL-4 and IL-10 in the research group were significantly higher than those in the control group(P<0.05); the level of IL-6 in the research group was significantly lower than that in the control group(P<0.05). The levels of PAI-1 and TGF-β in the research group were significantly lower than those in the control group(P<0.05). The levels of LH, FSH and T in the research group were significantly lower than those in the control group(P<0.05). The level of E2 in the research group was significantly higher than that in the control group(P<0.05). The levels of PI and RI in the research group were significantly lower than those in the control group(P<0.05). And the endometrial thickness in the research group was significantly thicker than that in the control group(P<0.05). Significantly more intraoperative blood loss and longer postoperative hospital stay were observed in the research group than those in the control group(P<0.05). The improvement rate of menstruation in the research group(96.36%) was significantly higher than that in the control group(81.81%)(P<0.05). The total effective rate in the research group(98.18%) was significantly higher than that in the control group(83.64%)(P<0.05). The incidence of intrauterine adhesions in the research group(5.46%) was lower than that in the control group(27.27%). Conclusion Hysteroscopic cold knife technique in the treatment of patients with intrauterine adhesions can inhibit inflammation, regulate TGF-β1, PAI-1, MMP-9 and hormone levels, impove ovarian blood supply, protect endometrium, improve clinical efficacy, and areduce the incidence of intrauterine adhesion.更多还原