Comparison Of The Effect Of Fractional Operation And One-off Separation Operation In The Treatment Of Severe Intrauterine Adhesions

OBJECTIVE: This study retrospectively analyzed the efficacy of fractional separation surgery and one-time separation surgery in the treatment of severe intrauterine adhesions,and compared the superior surgical methods by statistical methods,thus make reference.for the surgical treatment of severe intrauterine adhesions.METHODS: From January 2015 to June 2018,63 patients with severe intrauterine adhesions that underwent hysteroscopic Adhesionlysis in Second minimally invasive gynecology of our hospital were selected from the study.Professor Zhao Fujie,as a surgeon,was approved by the ethics committee of the hospital and signed an informed consent form.Among them,18 cases underwent fractional separation surgery,that is,the first operation only opened 1/2 to 2/3 uterine cavity,and the operation was supplemented with hormones.After 3 cycles of intimal growth,a second operation was performed to open all the uterine cavity.45 patients underwent one-time separation surgery.By observing postoperative menstrual recovery,postoperative uterine cavity recovery and intrauterine adhesion score(American Reproductive Medicine Association AFS score),etc.,using SPSS17.0 statistical software for analysis,counting variable data t test analysis(rank sum test was not satisfied for normal distribution data),and categorical variables were tested by chi-square test for hypothesis test.The difference was statistically significant at p<0.05.RESULTS: The age,the number of previous intrauterine operations,the endometrium,and the AFS score of the patients in the fractional operation and the one-time operation group were compared.The results showed that there were no significant differences between the two groups(p>0.05).The preoperative general condition of the group of patients was comparable.The overall efficacy of the two groups of patients after treatment,the results showed that the morphological recovery rate of the uterine cavity in the sub-operative group was 94.4%.The morphological recovery rate of the uterine cavity in the one-time separation group was 64.4%,and the difference between the two groups wasstatistically significant(p<0.05).The menstrual recovery in the two groups showed that the menstrual recovery rate was 88.9% in the divided operation group and 57.8%in the one-time separation group.The difference between the two groups was statistically significant(p<0.05).The postoperative intrauterine adhesion scores of the two groups showed that the AFS score was 4.67±1.53 after operation in the fractional operation group and the AFS score was 6.07±2.20 after the one-time separation group.The results showed that the AFS score of the postoperative operation group was obtained.,the difference was statistically significant(p < 0.05).Conclusions: Compared with the one-time operation group,the fractional operation group was more effective in the treatment of patients with severe intrauterine adhesions,the overall efficiency of postoperative menstruation,postoperative morphological recovery,and postoperative intrauterine adhesion score.