Efficacy of cold knife hysteroscopic surgery in treating intrauterine adhesions and its impact on uterine blood cir-culation and serum inflammatory factors
SHI Ya
ZHANG Qiong
ZHU Duan-rong
WU Fei-fei
ZENG Wei-wei
ZHAO Hao-yun
HU Yu-li
Abstract：Objective This study investigates the efficacy of cold knife hysteroscopic surgery for intrauterine ad-hesions(IUA)and its effects on uterine blood circulation and serum inflammatory markers.Methods A total of 132 IUA patients were randomly assigned into two groups:an observation group treated with hysteroscopic cold knife surgery(n=66)and a control group treated with hysteroscopic electrosurgery(n=66).Key indicators,including intraoperative metrics,recurrence rates of IUA,endometrial thickness,uterine artery pulsatility index(PI),resistance index(RI),and serum levels of inflammatory markers[interleukin-6(IL-6),transforming growth factor-β1(TGF-β1),and matrix metalloproteinase-9(MMP-9)],were monitored.Results Compared to the control group,the observation group exhibited significantly reduced intraoperative bleeding and distension fluid absorption and shorter operative time(P＜0.05);however,hospital stay duration was comparable(P＞0.05).At 1 month post-surgery,endometrial thick-ness was significantly higher(P＜0.05),and PI and RI values were significantly lower in the observation group(P＜0.05).Serum levels of IL-6 and TGF-β1 were also significantly lower,while MMP-9 levels were elevated in the ob-servation group(P＜0.05).The total effective rate was significantly higher in the observation group(98.48％)than in the control group(84.85％,P＜0.05).Follow-ups at 6 and 12 months revealed significantly lower recurrence rates in the observation group(6.06％and 9.09％)compared to the control group(18.18％and 21.21％,P＜0.05).Addi-tionally,the pregnancy rate at 12 months post-surgery was significantly higher in the observation group(65.15％)than in the control group(50.00％,P＜0.05).Conclusion Cold knife hysteroscopic surgery for IUA is highly effective,helping to preserve uterine blood flow,reduce inflammation,promote endometrial repair,lower recurrence risk,and improve pregnancy rates.
Keywords：intrauterine adhesionshysteroscopic cold knife separationendometriumblood circulationinflam-mation
Publication Date：2025-02-15
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 267-271 )