【摘要】 目的：探讨宫腔镜下冷刀切除术与双极电切术治疗宫腔粘连的临床效果。方法：选择2021年1月—2024年7月宜昌市中心人民医院收治的288例宫腔粘连患者，采用随机数字表法分为对照组(n=144)和观察组(n=144),分别行宫腔镜双极电切术和宫腔镜冷刀切除术。比较两组患者手术相关指标、子宫内膜厚度、粘连复发情况、妊娠情况及并发症发生情况。结果：观察组手术时间、术中出血量、膨宫液使用量、住院时间均少于对照组(均P<0.05)。术后2个月，观察组患者子宫内膜厚度[(9.52±1.52) mm vs (8.69±1.27) mm]显著高于对照组(P<0.05)。观察组患者总妊娠率(90.28%vs 79.17%)高于对照组，粘连复发率(6.94%vs 20.83%)低于对照组(均P<0.05)。观察组和对照组患者并发症总发生率(3.47%vs 4.17%)差异无统计学意义(P>0.05)。结论：宫腔镜下冷刀切除术治疗宫腔粘连的效果确切，可有效减少手术时间、术中出血及住院时间，改善子宫内膜厚度，明显降低宫腔粘连复发率，且安全性良好。更多还原

【Abstract】 Objective: To assess the clinical effectiveness of hysteroscopic cold knife resection and bipolar electrocautery techniques for managing intrauterine adhesions. Methods: A total of 288 patients with intrauterine adhesions treated in Yichang Central People’s Hospital from January 2021 to July 2024 were randomly divided into a control group(n=144) and an observation group(n=144) using a random number table method. They underwent hysteroscopic bipolar resection and hysteroscopic cold knife resection, respectively. The surgical related indicators, endometrial thickness, adhesion recurrence, pregnancy outcomes, and incidence of complications were compared between the two groups. Results: The observation group had less surgical time, intraoperative bleeding, use of uterine distension fluid, and hospital stay than those of control group(all P<0.05). Two months after the operation, the endometrial thickness of patients in the observation group [(9.52±1.52) mm vs(8.69±1.27) mm] was significantly higher than that of the control group(P<0.05). The total pregnancy rate of the observation group(90.28% vs 79.17%) was higher than that of the control group, and the recurrence rate of adhesions(6.94% vs 20.83%) was significantly lower than that of the control group(both P<0.05). There was no statistically significant difference in the total incidence of complications between the observation group and the control group(3.47% vs 4.17%)(P>0.05). Conclusion: The cold knife resection under hysteroscopy has a definite effect on the treatment of intrauterine adhesions, which can effectively reduce surgical time, intraoperative bleeding, and hospitalization time, improve endometrial thickness, significantly reduce the recurrence rate of intrauterine adhesions, and has good safety.更多还原