The Effect And Mechanism Study Of Balloon Combined With Biomembrane On Adhesion Again After Transcervical Resection Of Adhesions

Objective To evaluate the effect and mechanism study of balloon combined with biomembrane on adhesion again after ranscervical resection of adhesions(TCRA). Methods 120 severe intrauterine adhesion patients with TCRA were divided into control group(n=60) and observation group(n=60).The control group was given water filled balloon + estrogen /progestin. The observation group was given absorbable biomembrane + water filled balloon+ estrogen /progestin. The postoperative intrauterine adhesion rate,menstrual blood volume, dysmenorrhea rate, serum and endometrial tissue matrix metallo proteinases-9(MMP-9) and transforming growth factor-β(TGF-β) were compared between the two groups. Results Postoperation 3months, the intrauterine adhesions rate of control group was 31.7%(19/60),those of observation group was 10.0%(6/60), showed significant differences between the two groups(P<0.05). The menstrual blood volume of observation group significantly higher than control group, showed significant differences between the two groups(P<0.05). The menstruation improvement rate of control group was 85.0%(51/60), those of observation group was 96.7%(58/60), showed significant differences between the two groups(P<0.05).Two groups of patients with dysmenorrhea rates are lower than the properative,but the dysmenorrhea rate of two group was no significant differences(P>0.05). Preoperative serum and endometrial tissues MMP-9and there was no statistically significant difference comparing the TGF-β1level(P>0.05). Postoperation 3 months, the serum MMP-9 and TGF-β1 level of two group was significant differences(P < 0.05). The MMP-9 level in endometrial tissue of observation group significantly higher than control group, showed significant differences between the two groups(P<0.05). The TGF-β1 level in endometrial tissue of observation group significantly lower than control group, showed significant differences between the two groups(P<0.05). Conclusion Using balloon combined with biomembrane after transcervical resection of adhesions, can effectively prevent postoperative adhesion again, adjust of endometrial tissue expression of MMP-9 and TGF-β1 is the possible mechanism.