Effect of Hysteroscopic Cold Knife Technique on the Treatment Outcome and Inflammatory Stress Response in Patients with Endometrial Polyps

YANG Fan; LIU Chunling; GUO Xueting

doi:10.3969/j.issn.1004-437X.2025.10.020

Abstract：Objective To analyze the effect of hysteroscopic cold knife technique on the treatment outcome and inflammatory stress response in patients with endometrial polyps(EP).Methods A case study was conducted in the Second People's Hospital of Henan Province from November 2020 to November 2023.A total of 96 EP patients who strictly met the inclusion and exclusion criteria were selected as the research objects,and they were randomly divided into a hysteroscopic cold knife group and a hysteroscopic electrocision group,with 48 cases in each group.The hysteroscopic cold knife group received hysteroscopic cold knife,and the hysteroscopic electrocision group received hysteroscopic electrocision.The perioperative conditions,pain scores,menstrual volume,endometrial thickness,pulsatility index(PI),resistance index(RI),vascular endothelial growth factor(VEGF),inflammatory factors[high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor alpha(TNF-α)],and the incidence of complications were compared between the two groups.Results The operation time,postoperative bleeding time,and hospital stay in the hysteroscopic cold knife group were shorter than those in the hysteroscopic electrocision group,and the intraoperative blood loss was less than that in the hysteroscopic electrocision group(P＜0.05).At 12,24,and 48 h postoperatively,the pain scores of the patients in the hysteroscopic cold knife group were lower than those of the patients in the hysteroscopic electrodesiccation group(P＜0.05),and the comparison of the time interaction of pain scores of the two groups was statistically significant(P＜0.05).At 3 months after surgery,the menstrual volume of the hysteroscopic cold knife group was less than that of the hysteroscopic electrocision group,and the endometrial thickness was thinner than that of the hysteroscopic electrocision group(P＜0.05).At 3 months after surgery,the PI and RI of the hysteroscopic cold knife group were lower than those of the hysteroscopic electrocision group(P＜0.05).At 3 months after surgery,the VEGF level of the hysteroscopic cold knife group was lower than that of the hysteroscopic electrocision group(P＜0.05).At 1 and 3 d postoperatively,the hs-CRP and TNF-α levels of patients in the hysteroscopic cold knife group were lower than those of patients in the hysteroscopic electrodesiccation group(P＜0.05),and there was a statistically significant comparison of the time interaction of hs-CRP and TNF-α levels between the two groups(P＜0.05).The incidence of complications in the hysteroscopic cold knife group was 2.08％(1/48),which was lower than that in the hysteroscopic electrocision group(16.67％,8/48)(P＜0.05).Conclusion Hysteroscopic cold knife in EP patients can reduce surgical trauma,reduce inflammatory stress response,and relieve postoperative pain,and the incidence of complications can be reduced,which can accelerate uterine recovery.