Value of biomimetic electrical stimulation combined with long-term placement of balloon uterine stent in prevention of recurrence after separation of intrauterine adhesions

doi:10.3760/cma.j.issn.1007-1245.2023.22.030

Abstract

Abstract:

Objective　To explore the value of biomimetic electrical stimulation therapy combined with long-term placement of balloon uterine stents in the prevention of recurrence after intrauterine adhesions (IUA) separation surgery (TCRA). Methods　Ninety patients with IUA who were scheduled to undergo TCRA at Haizhu District Maternal and Child Health Care Hospital from January 2022 to April 2023 were selected for the randomized controlled trial, and were divided into a control group and an experimental group by the random number table method, with 45 cases in each group. The control group were (28.58±5.84) years old, and the experimental group were (28.41±5.08) years old. The control group were treated with long-term placement of balloon uterine stents and artificial cycle therapy after surgery; the experimental group were treated with long term placement of balloon uterine stents, artificial cycle therapy, and biomimetic electrical stimulation therapy after surgery. All the patients were followed up after surgery. The recovery of uterine cavity morphology, endometrial receptivity indicators, recurrence rates of IUA, menstrual improvement, pregnancy rates, and positive cervical secretion culture, and levels of serum inflammatory factors and adhesion factors before and after surgery were compared between the two groups. t and χ² tests were used. Results　The total effective rate of uterine cavity morphology recovery, postoperative pregnancy rate, and menstrual improvement rate in the experimental group were significantly higher than those in the control group. The total postoperative recurrence rate of IUA in the experimental group was significantly lower than that in the control group [(11.11% (5/45) vs. 31.11% (14/45); χ²=5.404, P<0.05]. The endometrial thickness of the experimental group 3 months after surgery was significantly higher than that of the control group [(8.55±0.87) mm vs. (7.01±0.96) mm; t=7.974, P<0.05]. The levels of serum tumor necrosis factor-α (TNF-α) and transforming growth factor-β1 (TGF-β1) 3 months after surgery in the experimental group were significantly lower than those in the control group [(31.58±8.24) ng/L vs. (47.01±7.66) ng/L and (32.11±5.37) μg/L vs. (38.05±4.62) μg/L; t=9.200 and 5.625, both P<0.05]. Conclusions　The combination of biomimetic electrical stimulation therapy and long-term placement of balloon uterine stents has a good effect in preventing recurrence after TCRA surgery. It can effectively promote the recovery of uterine cavity morphology, improve their menstrual and pregnancy conditions and endometrial receptivity, and reduce the levels of serum TNF-α and TGF-β1.

Key words:

Balloon uterine stent, Intrauterine adhesion separation, Biomimetic electrical stimulation, Recurrence

摘要：

目的　探讨仿生物电刺激治疗联合长时间放置球囊子宫支架预防宫腔粘连（IUA）分离术（TCRA）后复发的价值。方法　选取2022年1月至2023年4月广州市海珠区妇幼保健院收治的90例拟行TCRA治疗的IUA患者进行随机对照试验，采用随机数字表法将其分为对照组和试验组，各45例。对照组年龄（28.58±5.84）岁，试验组年龄（28.41±5.08）岁。对照组术后采用长时间放置球囊子宫支架+人工周期治疗；试验组术后采用长时间放置球囊子宫支架+人工周期治疗+仿生物电刺激治疗。术后随访所有患者。比较两组术后宫腔形态恢复情况、子宫内膜容受性指标、宫腔粘连复发率、月经改善情况、妊娠率、宫颈分泌物培养阳性情况、手术前后血清炎性因子和粘连因子水平。采用t检验和χ²检验。结果　试验组宫腔形态恢复总有效率、术后妊娠率以及月经改善率高于对照组；试验组术后IUA总复发率低于对照组［11.11%（5/45）比31.11%（14/45），χ²⁼5.404，P<0.05］。试验组术后3个月子宫内膜厚度明显高于对照组［（8.55±0.87）mm比（7.01±0.96）mm，t=7.974，P<0.05］。试验组术后3个月血清肿瘤坏死因子-α（TNF-α）、转化生长因子-β1（TGF-β1）水平明显低于对照组［（31.58±8.24）ng/L比（47.01±7.66）ng/L、（32.11±5.37）μg/L比（38.05±4.62）μg/L，t=9.200、5.625，均P<0.05］。结论　仿生物电刺激治疗联合长时间放置球囊子宫支架在预防TCRA术后复发中效果良好，可有效促进患者宫腔形态恢复，改善月经和妊娠情况，改善子宫内膜容受性，降低血清TNF-α、TGF-β1水平。

关键词:

球囊子宫支架, 宫腔粘连分离术, 仿生物电刺激, 复发

Dong Fanghua, Wang Zhidan, Li Miaozhu, Yan Haijie.

Value of biomimetic electrical stimulation combined with long-term placement of balloon uterine stent in prevention of recurrence after separation of intrauterine adhesions [J]. International Medicine and Health Guidance News, 2023, 29(22): 3274-3279.

董方华王志丹李苗珠严海杰.

仿生物电刺激治疗联合长时间放置球囊子宫支架预防宫腔粘连分离术后复发的价值 [J]. 国际医药卫生导报, 2023, 29(22): 3274-3279.

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