Comparison Of Clinical Efficacy Between Hysteroscopic Cold Knife And Electric Resection For Moderate Intrauterine Adhesions

Objective: The treatment of intrauterine adhesions(IUA)is a hotspot point in recent years.A number of new hysteroscopic surgical instruments have been developed in order to protect women's menstrual and reproductive functions,including cold knives.The research about the difference between the treatment effect of cold knife and electric cutting is still not much.Therefore,this trial is designd to understand the safety and efficacy of hysteroscopic cold knife devices in the treatment of moderate intrauterine adhesions,and provide evidence for accurate medical decision-making.Methods: The 70 patients with moderate intrauterine adhesions receiving treatment at the Hysteroscopic Center of the Maternal and Child Health Hospital of Jiangxi Province,they all surgery by director Cao Huabin,selected from June 2018 to December 2018.Among them,35 cases of cold knife and 35 cases of electric cutting.Surgical data(intraoperative complications and surgical costs)and postoperative follow-up data(intrauterine morphology,intrauterine re-adhesion,endometrial repair at 1 month;postoperatively,menstruation and pregnancy in 6 months)were collected to statistical analysis.Results: No complications occurred during the surgery.The surgical cost of the cold knife group was 1486.35±78.60 yuan,which was significantly lower than that of the electric cutting group of 1862.71±127.00 yuan(P?0.05).The satisfactory rate of endometrial repair in the cold knife group(90.6%)was significantly higher than that in the electric cutting group(12.5%)(P?0.05).In the first month after operation,the uterine morphology was restored in the cold knife group(96.9%)and the electric cut group(100%)(P?0.05).The rate of uterine re-adhesion was 1 in the cold knife group(9.4%)and the electric cut group(0%)(P?0.05).The postoperative menstrual improvement rate was cold knife group(34.4%)and electric cut group(25.0%)(P?0.05).The postoperative pregnancy rate was cold knife group(40.6%)and electric cut group(40.6%)(P?0.05).Conclusion:Comparison of clinical efficacy between hysteroscopic cold knife and electric resection for moderate intrauterine adhesions,the occurrence of intraoperative complications,the recovery of uterine morphology one month after surgery,the re-adhesion of uterine cavity one month after surgery,the menstrual recovery and pregnancy in six moths are similar,which way be selected according to the operator's proficiency.Cold knife treatment costs have obvious advantages,may be more useful for patients with poor economic conditions.The repair of the endometrium after cold knife treatment is faster than the electric cut,patients with fertility requirements in short-term have greater use value.Therefore,hysteroscopic cold knife is a good choice for the treatment of moderate intrauterine adhesions.